WorldWideScience

Sample records for chronic gastrointestinal manifestations

  1. The chronic gastrointestinal manifestations of Chagas disease

    Directory of Open Access Journals (Sweden)

    Nilce Mitiko Matsuda

    2009-01-01

    Full Text Available Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer.

  2. Gastrointestinal manifestations of endocrine disease

    Institute of Scientific and Technical Information of China (English)

    Christina Maser; Arnbjorn Toset; Sanziana Roman

    2006-01-01

    The hormonal interactions among the systems throughout the body are not fully understood; many vague clinical symptoms may in fact be manifestations of underlying endocrine diseases. The aim of the following review is to discuss gastrointestinal manifestations of surgically correctable endocrine diseases, focusing on abnormalities of thyroid function, cancer and finally autoimmune diseases. We also review manifestations of pancreatic endocrine tumors, and multiple endocrine neoplasia.

  3. Russell Body Gastroenteritis: An Aberrant Manifestation of Chronic Inflammation in Gastrointestinal Mucosa

    OpenAIRE

    Feriyl Bhaijee; Brown, Keith A.; Long, Billy W.; Brown, Alexandra S.

    2013-01-01

    First described in 1998, Russell body gastritis is a rare chronic inflammatory condition characterized by abundant intramucosal polyclonal plasma cells, which contain intracytoplasmic eosinophilic globules of immunoglobulins (Russell bodies) that displace the nucleus, with an accompanying chronic inflammatory infiltrate. Russell bodies represent a cellular response to overstimulation of plasma cells, leading to the accumulation of abundant, nondegradable, condensed immunoglobulin in dilated r...

  4. Russell Body Gastroenteritis: An Aberrant Manifestation of Chronic Inflammation in Gastrointestinal Mucosa

    Directory of Open Access Journals (Sweden)

    Feriyl Bhaijee

    2013-01-01

    Full Text Available First described in 1998, Russell body gastritis is a rare chronic inflammatory condition characterized by abundant intramucosal polyclonal plasma cells, which contain intracytoplasmic eosinophilic globules of immunoglobulins (Russell bodies that displace the nucleus, with an accompanying chronic inflammatory infiltrate. Russell bodies represent a cellular response to overstimulation of plasma cells, leading to the accumulation of abundant, nondegradable, condensed immunoglobulin in dilated rough endoplasmic reticulum cisternae. Russell body gastritis usually occurs in the gastric antrum, but two cases of Russell body duodenitis have been recently described. Herein, we report an unusual case of Barrett esophagus with prominent lymphoplasmacytic infiltration and Russell bodies, which expands the current spectrum of Russell body gastritis/duodenitis. Given the various anatomic locations in which Russell body gastritis may arise, we suggest that “Russell body gastroenteritis” may be a more appropriate designation for this uncommon reactive condition.

  5. Gastrointestinal manifestations of food allergies.

    Science.gov (United States)

    Wolfe, Jaime Liou; Aceves, Seema S

    2011-04-01

    The rates of eosinophilic gastrointestinal disorders appear to be increasing. The most common of these is eosinophilic esophagitis (EoE) which is a clinicopathologic condition consisting of characteristic symptoms and endoscopic features accompanied by a pan-esophageal, acid resistant epithelial eosinophilia of greater than equal to 15 per high power field. Typical symptoms include dysphagia and abdominal pain. Typical endoscopic features include pallor, plaques, furrows, concentric rings. Complications include food impactions and strictures. EoE resolution with food elimination diets provides evidence that EoE is a food-antigen driven process. In vitro and microarray studies have identified specific immunologic factors underlying EoE pathogenesis. Other gastrointestinal manifestations of food intolerances/allergy include food protein induced enterocolitis syndrome.

  6. Chronic ulcerative gastroduodenitis as a first gastrointestinal manifestation of Hermansky-Pudlak syndrome in a 1O-year-old child

    Institute of Scientific and Technical Information of China (English)

    Anselm Chi-Wai Lee; Kin-Hung Poon; Wing-Hong Lo; Lap-Gate Wong

    2008-01-01

    A 10-year-old Chinese boy who had a history of congenital thrombocytopathy presented with severe iron deficiency anemia secondary to chronic gastric inflammation and duodenal ulcerations. Subtle oculocutaneous albinism led to the finding of diminished dense bodies in the platelets under electron microscopy,hence the diagnosis of Hermansky-Pudlak syndrome (HPS). Biopsies from the stomach and duodenumrevealed a lymphocytic infiltration in the submucosa,but H pylori infection was absent. The gastroduodenitis responded to the treatment with omeprazole while iron deficiency anemia was corrected by oral iron therapy.HPS is a rare cause of congenital bleeding disorder with multisystemic manifestations. Upper gastrointestinal involvement is rare and should be distinguished from a mere manifestation of the bleeding diathesis.

  7. Gastrointestinal manifestations in myotonic muscular dystrophy

    Institute of Scientific and Technical Information of China (English)

    Massimo Bellini; Sonia Biagi; Cristina Stasi; Francesco Costa; Maria Gloria Mumolo; Angelo Ricchiuti; Santino Marchi

    2006-01-01

    Myotonic dystrophy (MD) is characterized by myotonic phenomena and progressive muscular weakness.Involvement of the gastrointestinal tract is frequent and may occur at any level. The clinical manifestations have previously been attributed to motility disorders caused by smooth muscle damage, but histologic evidence of alterations has been scarce and conflicting.A neural factor has also been hypothesized. In the upper digestive tract, dysphagia, heartburn, regurgitation and dyspepsia are the most common complaints, while in the lower tract, abdominal pain, bloating and changes in bowel habits are often reported. Digestive symptoms may be the first sign of dystrophic disease and may precede the musculo-skeletal features. The impairment of gastrointestinal function may be sometimes so gradual that the patients adapt to it with little awareness of symptoms. In such cases routine endoscopic and ultrasonographic evaluations are not sufficient and targeted techniques (electrogastrography, manometry,electromyography, functional ultrasonography,scintigraphy, etc.) are needed. There is a low correlation between the degree of skeletal muscle involvement and the presence and severity of gastrointestinal disturbances whereas a positive correlation with the duration of the skeletal muscle disease has been reported.The drugs recommended for treating the gastrointestinal complaints such as prokinetic, antidyspeptic drugs and laxatives, are mainly aimed at correcting the motility disorders.Gastrointestinal involvement in MD remains a complex and intriguing condition since many important problems are still unsolved. Further studies concentrating on genetic aspects, early diagnostic techniques and the development of new therapeutic strategies are needed to improve our management of the gastrointestinal manifestations of MD.

  8. Paraneoplastic dermatological manifestation of gastrointestinal malignancies

    Institute of Scientific and Technical Information of China (English)

    Lyubomir A Dourmishev; Peter V Draganov

    2009-01-01

    Numerous dermatological disorders have been associated with underlining malignancies of the gastrointestinal (GI) tract. Such cutaneous manifestations might have an important diagnostic value if they are the sole expressions of otherwise asymptomatic carcinomas. The recognition of some typical paraneoplastic dermatologic disorders can lead to the prompt diagnosis of the underlying malignancy, timely administration of therapy, and ultimately, better prognosis. In this review we discuss the most common paraneoplastic dermatological syndromes from the perspective of the practicing gastroenterologist. We also outline a comprehensive practical approach for the evaluation for occult malignancy in patients presenting with cutaneous findings potentially associated with GI cancers.

  9. Gastrointestinal symptomatology as first manifestation of systemic erythematous lupus

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    Kovačević Zoran

    2009-01-01

    Full Text Available Background. Systemic lupus erithematodes (SLE is chronic, often febrile, multisystemic disease unknown origin and relapsing course which affects connective tissue of the skin, joints, kidney and serous membranes. Gastrointestinal manifestations are rarely the first sign of systemic lupus erythematosus. Case report. We presented a female patient, 35 years old, whose first symptoms of SLE were paralitic ileus (chronic intestinal pseudo-obstruction and polyserositis (pleural effusion and ascites. Except for high parameters of inflammation, leucopenia and thrombocytopenia, all immunological and laboratory tests for SLE were negative in the onset of the disease. During next six months the patient had clinical signs of paralitic ileus several times and was twice operated with progressive malabsorptive syndrome. The full picture of SLE was manifested seven months later associated with lupus nephritis. Treatment with cyclophosphamide, corticosteroids and total parenteral nutrition (30 days induced stable remission of the disease. Conclusion. The SLE can be initially manifested with gastroenterological symptoms without any other clinical and immunologic parameters of the disease. If in patients with SLE and gastrointestinal tract involvement malabsorption syndrom is developed, a treatment success depends on both immunosupressive therapy and total parenteral nutrition.

  10. Gastrointestinal, Pancreatic, and Hepatobiliary Manifestations of Cystic Fibrosis.

    Science.gov (United States)

    Sathe, Meghana Nitin; Freeman, Alvin Jay

    2016-08-01

    Pulmonary disease is the primary cause of morbidity and mortality in people with cystic fibrosis (CF), but significant involvement within gastrointestinal, pancreatic, and hepatobiliary systems occurs as well. As in the airways, defects in CFTR alter epithelial surface fluid, mucus viscosity, and pH, increasing risk of stasis through the various hollow epithelial-lined structures of the gastrointestinal tract. This exerts secondary influences that are responsible for most gastrointestinal, pancreatic, and hepatobiliary manifestations of CF. Understanding these gastrointestinal morbidities of CF is essential in understanding and treating CF as a multisystem disease process and improving overall patient care. PMID:27469182

  11. Gastrointestinal manifestation's history in the systemic lupus erythematosus

    International Nuclear Information System (INIS)

    In this paper we reviewed the history of the gastrointestinal manifestations in systemic lupus erythematosus since century XIX to our days, making a review of every organ and system involved, with special emphasis in gastropathy, enteritis, ileitis, malabsorption syndrome vasculitis bowel vasculopathy, mesenteric thrombosis, pancreatitis, ascites, peritonitis autoimmune hepatitis and more

  12. Gastrointestinal and hepatic manifestations of sarcoidosis.

    Science.gov (United States)

    Ebert, Ellen C; Kierson, Malca; Hagspiel, Klaus D

    2008-12-01

    Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in the affected organs, including skin, heart, nervous system, and joints. Diagnosis of sarcoidosis is generally based upon a compatible history, demonstration of granulomas in at least two different organs, negative staining and culture for acid fast bacilli, absence of occupational or domestic exposure to toxins, and lack of drug-induced disease. Involvement of the hollow organs is rare. Rather than being due to sarcoidosis, some reported mucosal lesions may simply have incidental granulomas. Extrinsic compression from lymphadenopathy can occur throughout the gastrointestinal tract. The stomach, particularly the antrum, is the most common extrahepatic organ to be involved, while the small bowel is the least common. Liver involvement frequently occurs and ranges from asymptomatic incidental granulomas to portal hypertension from granulomas in the portal triad, usually with relatively preserved liver function. CT scans show hepatosplenomegaly and adenopathy, followed in frequency by focal low-attenuation lesions of the liver and spleen. Ascites is usually a transudate from right heart failure (because of pulmonary hypertension) or portal hypertension (because of biliary cirrhosis). Rarely, an exudative ascites may occur from studding of the peritoneum with nodules. Pancreatic involvement presents as a mass, usually in the head or a diffusely firm, nodular organ. Corticosteroids should be instituted when organ function is threatened, usually lungs, eyes, and central nervous system. Their role in the treatment of hepatic sarcoidosis is unclear. The overall prognosis is good although most patients will have some permanent organ impairment. Cardiac and pulmonary diseases are the main causes of death. PMID:18853979

  13. Massive ascites as a presenting manifestation of chronic lymphocytic leukemia

    Institute of Scientific and Technical Information of China (English)

    Neelam Siddiqui; Saeed Al-Amoudi; Aamer Aleem; Maha Arafah; Layla Al-Gwaiz

    2008-01-01

    Ascites is not an uncommon manifestation of certain solid tumors like gastrointestinal malignancies, ovarian cancer and breast cancer. However, it is unusual to encounter ascites in patients with hematological malignancies especially chronic leukemia. The patient described here presented with massive ascites and blood lymphocytosis. Further studies confirmed the diagnosis of chronic lymphocytic leukemia with ascites. The ascitic fluid was exudative, consisting of mature-looking B-lymphocytes, which were morphologically and immunophenotypically similar to peripheral blood and bone marrow cells. The patient was treated with chemotherapy and achieved a good response and diminution of ascitic fluid accumulation.

  14. Lower Gastrointestinal Bleeding in Chronic Hemodialysis Patients

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    Fahad Saeed

    2011-01-01

    Full Text Available Gastrointestinal (GI bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI in chronic kidney disease (CKD and end-stage renal disease (ESRD patients. We suggest an approach to diagnosis and management of this problem.

  15. Chronic polyarthritis as isolated manifestation of toxocariasis.

    Science.gov (United States)

    Viola, Gabriela R; Giacomin, Maria Fernanda A; França, Camila M P; Sallum, Adriana M E; Jacob, Cristina M A; Silva, Clovis A

    2016-01-01

    Human toxocariasis is a parasitic zoonosis mainly caused by Toxocara canis or Toxocara cati and is acquired by ingestion of the parasite's embryonated eggs. Arthralgia and/or arthritis were reported in up to 17% of the cases, generally with acute duration (less than 6 weeks). However, to our knowledge, chronic polyarthritis, as the isolated presentation of Toxocara infection, was not reported. One of the 5809 patients that was followed up at our service (0.017%) had chronic polyarthritis as the single manifestation of toxocariasis and was described herein. A 3-year-old girl was referred to our service with severe painful chronic polyarthritis for a period longer than 10 weeks and morning stiffness of 30min. Dog contact exposure history in the recreational areas of neighborhood was reported. Her exams showed high levels of eosinophils in peripheral blood (29%), bone marrow aspirate revealed marked eosinophilia (32%) and Toxocara enzyme-linked immunosorbent assay (Elisa) was positive (1:1280). She was treated with paracetamol (40mg/kg/day) and thiabendazole (25mg/kg/day) for 10 days, and all manifestations reduced. After eight months of follow-up, she was on clinical and laboratorial remission. In conclusion, we described a case of chronic polyarthritis, as isolated manifestation of toxocariasis, mimicking juvenile idiopathic arthritis and leukemia. Importantly, this zoonosis should be considered in patients with arthritis and eosinophilia.

  16. Chronic polyarthritis as isolated manifestation of toxocariasis.

    Science.gov (United States)

    Viola, Gabriela R; Giacomin, Maria Fernanda A; França, Camila M P; Sallum, Adriana M E; Jacob, Cristina M A; Silva, Clovis A

    2016-01-01

    Human toxocariasis is a parasitic zoonosis mainly caused by Toxocara canis or Toxocara cati and is acquired by ingestion of the parasite's embryonated eggs. Arthralgia and/or arthritis were reported in up to 17% of the cases, generally with acute duration (less than 6 weeks). However, to our knowledge, chronic polyarthritis, as the isolated presentation of Toxocara infection, was not reported. One of the 5809 patients that was followed up at our service (0.017%) had chronic polyarthritis as the single manifestation of toxocariasis and was described herein. A 3-year-old girl was referred to our service with severe painful chronic polyarthritis for a period longer than 10 weeks and morning stiffness of 30min. Dog contact exposure history in the recreational areas of neighborhood was reported. Her exams showed high levels of eosinophils in peripheral blood (29%), bone marrow aspirate revealed marked eosinophilia (32%) and Toxocara enzyme-linked immunosorbent assay (Elisa) was positive (1:1280). She was treated with paracetamol (40mg/kg/day) and thiabendazole (25mg/kg/day) for 10 days, and all manifestations reduced. After eight months of follow-up, she was on clinical and laboratorial remission. In conclusion, we described a case of chronic polyarthritis, as isolated manifestation of toxocariasis, mimicking juvenile idiopathic arthritis and leukemia. Importantly, this zoonosis should be considered in patients with arthritis and eosinophilia. PMID:27267534

  17. Gastrointestinal amyloidosis: a case of chronic diarrhoea.

    Science.gov (United States)

    Fonnesu, C; Giovinale, M; Verrecchia, E; De Socio, G; Cerquaglia, C; Curigliano, V; Soriano, A; Obici, L; Grieco, A; Lauriola, L; Gasbarrini, G; Manna, R

    2009-03-01

    Amyloidosis is a rare disease caused by extracellular deposits of insoluble fibrillar proteins in various organs and tissues. There are different forms of amyloidosis distinguished by the type of protein fibrils, by the sites of deposition and by associated conditions. Gastrointestinal involvement is common both in primary and secondary amyloidosis, while isolated gastrointestinal amyloidosis is rare. We describe a case of AL amyloidosis with a gastrointestinal involvement and restrictive cardiomiopathy. A 64 year old woman came to our attention with a history of chronic diarrhoea and weight loss, associated with dysphagia, dry mouth, xerophtalmia, chronic gastritis and depression. Clinical diagnosis has been difficult because of aspecificity of symptoms that mimed other more common diseases, like gastro-paresis, epigastric discomfort, gastric or duodenal ulcers, perforation, malabsorption, intestinal pseudo-obstruction. There is an important risk of misunderstanding and diagnostic delay. Indeed in this patient a diagnosis of irritable colon syndrome was erroneously established two years before admission in our hospital. Therefore gastrointestinal amyloidosis should be considered among differential diagnoses of chronic diarrhoea and weight loss when other more common diseases have been excluded. PMID:19530511

  18. Chronic intractable diarrhea caused by gastrointestinal mastocytosis.

    Science.gov (United States)

    Seo, Hyungil; Park, Sang Hyoung; Byeon, Jeong-Sik; Woo, Chang Gok; Hong, Seung-Mo; Chang, Kiju; So, Hoonsub; Kwak, Minseob; Kim, Wan Soo; Lee, Jeong-Mi; Yang, Dong-Hoon; Kim, Kyung-Jo; Ye, Byong Duk; Myung, Seung-Jae; Yang, Suk-Kyun

    2016-07-01

    As mast cells have been highlighted in the pathogenesis of diarrhea-predominant irritable bowel syndrome, a new term "mastocytic enterocolitis" was suggested by Jakate and colleagues to describe an increase in mucosal mast cells in patients with chronic intractable diarrhea and favorable response to treatment with antihistamines. Although it is not an established disease entity, two cases have been reported in the English medical literature. Here, for the first time in Asia, we report another case of chronic intractable diarrhea caused by gastrointestinal mastocytosis. The patient was a 70-year-old male with chronic intractable diarrhea for 3 months; the cause of the diarrhea remained obscure even after exhaustive evaluation. However, biopsy specimens from the jejunum were found to have increased mast cell infiltration, and the patient was successfully treated with antihistamines. PMID:27433151

  19. Gastrointestinal Manifestations, Malnutrition, and Role of Enteral and Parenteral Nutrition in Patients With Scleroderma.

    Science.gov (United States)

    Bharadwaj, Shishira; Tandon, Parul; Gohel, Tushar; Corrigan, Mandy L; Coughlin, Kathleen L; Shatnawei, Abdullah; Chatterjee, Soumya; Kirby, Donald F

    2015-08-01

    Scleroderma (systemic sclerosis) is an autoimmune disease that can affect multiple organ systems. Gastrointestinal (GI) involvement is the most common organ system involved in scleroderma. Complications of GI involvement including gastroesophageal reflux disease, small intestinal bacterial overgrowth, and chronic intestinal pseudoobstruction secondary to extensive fibrosis may lead to nutritional deficiencies in these patients. Here, we discuss pathophysiology, progression of GI manifestations, and malnutrition secondary to scleroderma, and the use of enteral and parenteral nutrition to reverse severe nutritional deficiencies. Increased mortality in patients with concurrent malnutrition in systemic sclerosis, as well as the refractory nature of this malnutrition to pharmacologic therapies compels clinicians to provide novel and more invasive interventions in reversing these nutritional deficiencies. Enteral and parenteral nutrition have important implications for patients who are severely malnourished or have compromised GI function as they are relatively safe and have substantial retrospective evidence of success. Increased awareness of these therapeutic options is important when treating scleroderma-associated malnutrition. PMID:25992813

  20. Gastrointestinal Angiodysplasia in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Kaaroud H

    2008-01-01

    Full Text Available Gastrointestinal (GI hemorrhage is a frequent and sometimes life-threatening complication of end-stage renal failure. Angiodysplasia (AD, vascular malformation, is the most common cause of recurrent lower-intestinal hemorrhage in patients with renal failure. We report four chronic hemodialysis patients with AD. All patients presented with severe anemia requiring transfusion. GI hemorrhage ceased spontaneously in three cases and after treatment with argon plasma coagulation in another. Diagnosis of AD is usually challenging, since its cause is still unknown, and its clinical presentation is variable. Lesions are multiple in 40-75% of cases, often located in the stomach and duodenum but can affect the colon and the jejunum. Diagnosis is improved by endoscopy which has a much higher sensitivity compared to angiography. Capsular endoscopy may reveal the hemorrhage site in the small intestine when regular endoscopy fails, and therapeutic intervention usually include argon plasma coagulation.

  1. 78 FR 6404 - Agency Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf...

    Science.gov (United States)

    2013-01-30

    ... AFFAIRS Agency Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans....'' SUPPLEMENTAL INFORMATION: Titles: a. Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA... Persian Gulf War returned with persistent gastrointestinal symptoms, typical of...

  2. Gastrointestinal manifestations of Henoch-Schonlein purpura: A report of two cases

    Institute of Scientific and Technical Information of China (English)

    Parameswaran; Prathiba; Rajalakshmi; Kalyanasundaram; Srinivasan

    2015-01-01

    Henoch-Schonlein purpura(HSP) is a small vessel vasculitis mediated by type Ⅲ hypersensitivity with deposition of Ig A immune complex in the walls of vessels. It is a multi-system disorder characterizedby palpable purpura, arthritis, glomerulonephritis and gastrointestinal manifestations and commonly occurs in children and young adults. The patients with gastrointestinal involvement usually present with colicky abdominal pain, vomiting and melena. The imaging findings include multifocal bowel thickening with mucosal hyperenhancement, presence of skip areas, mesenteric vascular engorgement, with involvement of unusual sites like stomach, duodenum and rectum. These imaging findings in a child or young adult with appropriate clinical findings could suggest HSP.

  3. Serum Markers and Intestinal Mucosal Injury in Chronic Gastrointestinal Ischemia

    NARCIS (Netherlands)

    D. van Noord (Désirée); P.B.F. Mensink (Peter); R.J. de Knegt (Robert); M. Ouwendijk (Martine); J. Francke (Jan Paul); A.J. van Vuuren (Hanneke); B.E. Hansen (Bettina); E.J. Kuipers (Ernst)

    2010-01-01

    textabstractBackground: Diagnosing chronic gastrointestinal ischemia (CGI) is a challenging problem in clinical practice. Serum markers for CGI would be of great diagnostic value as a non-invasive test method. Aims: This study investigated serum markers in patients with well-defined ischemia. Furthe

  4. Extrahepatic manifestations of chronic hepatitis C virus infection.

    Science.gov (United States)

    Cacoub, Patrice; Comarmond, Cloe; Domont, Fanny; Savey, Léa; Desbois, Anne C; Saadoun, David

    2016-02-01

    During hepatitis C virus (HCV) chronic infection, extrahepatic manifestations are frequent and polymorphous. This article reports on a large cohort of patients with HCV-related autoimmune or lymphoproliferative disorders, from mixed cryoglobulinemia vasculitis to frank lymphomas. The relationship between HCV infection and such immune-related diseases has been formally demonstrated by epidemiological, clinical, immunological and pathological data, and results of therapeutic trials. More recently, other nonliver-related HCV disorders have been reported, including cardiovascular (i.e. stroke, ischemic heart disease), renal, metabolic and central nervous system diseases. For these manifestations, most evidence comes from large epidemiological studies; there is a need for mechanistic studies and therapeutic trials for confirmation. Beyond the risk of developing liver complications, that is, cirrhosis and liver cancer, patients with HCV infection have an increased risk of morbidity and mortality related to nonliver diseases. HCV chronic infection should be analyzed as a systemic disease in which extrahepatic consequences increase the weight of its pathological burden. The need for effective viral eradication measures is underlined. PMID:26862398

  5. Vertebral manifestation of chronic recurrent multifocal osteomyelitis (CRMO)

    International Nuclear Information System (INIS)

    Chronic recurrent multifocal osteomyelitis (CRMO) is a systemic osteo-articular disease that is characterized by a sterile, primarily chronic osteomyelitis with various distribution patterns of the individual lesions. In this article, we describe the 'axial type' with predominant involvement of the spine, which represents 13 of our 41 CMRO cases of different age groups. The important element of its diagnosis is the typical lympho-plasmacellular spondylitis that can be detected and staged by scintigraphy, MRI and conventional radiography. Potentially affected are all vertebrae from the mid-cervical spine to the sacrum. One or several segments can be involved, sometimes as transient inflammatory edema, sometimes as 'migratory spondylitis' or 'saltatory spondylitis', but also as chronic sclerosing type with early radiographically detectable manifestation. Vertebral deformity due to compression and total collapse (vertebra plana) are rare. A complicated course with patulous perivertebral edema can lead to concomitant symptomatic inflammatory changes in adjacent regions and organs. In the course of CRMO, spondylodiscitis only develops as secondary destruction following the spondylitis. This can help to differentiate spondyloarthropathies from CRMO that is initially detected as primary lesion in the spine. While CRMO generally has a good prognosis, its radiological differentiation from rheumatology conditions plays an important role. (orig.)

  6. Managing Inflammatory Manifestations in Patients with Chronic Granulomatous Disease.

    Science.gov (United States)

    Magnani, Alessandra; Mahlaoui, Nizar

    2016-10-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency caused by lack of phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, which results in inflammatory dysregulation and increased susceptibility to infections. Patients with CGD may develop severe obstructive disorders of the digestive tract as a result of their dysregulated inflammatory response. Despite a growing focus on inflammatory manifestations in CGD, the literature data on obstructive complications are far less extensive than those on infectious complications. Diagnosis and management of patients with concomitant predispositions to infections and hyperinflammation are particularly challenging. Although the inflammatory and granulomatous manifestations of CGD usually respond rapidly to steroid treatment, second-line therapies (immunosuppressants and biologics) may be required in refractory cases. Indeed, immunosuppressants (such as anti-tumor necrosis factor agents, thalidomide, and anakinra) have shown some efficacy, but the value of this approach is controversial, given the questionable risk-to-benefit ratio and the small numbers of patients treated to date. Significant progress in allogeneic hematopoietic stem cell transplantation (the only curative treatment for CGD) has been made through better supportive care and implementation of improved, reduced-intensity conditioning regimens. Gene therapy may eventually be an option for patients lacking a suitable donor; clinical trials with new, safer vectors are ongoing at a few centers. PMID:27299584

  7. 77 FR 64597 - Proposed Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf...

    Science.gov (United States)

    2012-10-22

    ... AFFAIRS Proposed Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf... disorders in Persian Gulf War Veterans. DATES: Written comments and recommendations on the proposed... Form (Control), VA Form 10-2109b. c. Survey of Chronic Gastrointestinal Illness in Persian...

  8. Eosinophilic gastroenteritis with refractory ulcer disease and gastrointestinal bleeding as a rare manifestation of seronegative gastrointestinal food allergy.

    Science.gov (United States)

    Raithel, Martin; Hahn, Markus; Donhuijsen, Konrad; Hagel, Alexander F; Nägel, Andreas; Rieker, Ralf J; Neurath, Markus F; Reinshagen, Max

    2014-09-17

    Gastrointestinal bleeding and iron deficiency anaemia may cause severe symptoms and may require extensive diagnostics and substantial amounts of health resources.This case report focuses on the clinical presentation of a 22 year old patient with recurrent gastrointestinal bleeding from multilocular non-healing ulcers of the stomach, duodenum and jejunum over a period of four years. Extensive gastroenterological and allergological standard diagnostic procedures showed benign ulcerative lesions with tissue eosinophilia, but no conclusive diagnosis. Multiple diagnostic procedures were performed, until finally, endoscopically guided segmental gut lavage identified locally produced, intestinal IgE antibodies by fluoro-enzyme-immunoassay.IgE antibody concentrations at the intestinal level were found to be more-fold increased for total IgE and food-specific IgE against nuts, rye flour, wheat flour, pork, beef and egg yolk compared with healthy controls.Thus, a diet eliminating these allergens was introduced along with antihistamines and administration of a hypoallergenic formula, which resulted in complete healing of the multilocular ulcers with resolution of gastrointestinal bleeding. All gastrointestinal lesions disappeared and total serum IgE levels dropped to normal within 9 months. The patient has been in remission now for more than two years.Eosinophilic gastroenteritis (EG) is well known to induce refractory ulcer disease. In this case, the mechanisms for intestinal damage and gastrointestinal bleeding were identified as local gastrointestinal type I allergy. Therefore, future diagnostics in EG should also be focused on the intestinal level as identification of causative food-specific IgE antibodies proved to be effective to induce remission in this patient.

  9. Heterotopic gastrointestinal cyst mimicking chronic cholecystitis: a case report

    Directory of Open Access Journals (Sweden)

    Popkharitov Angel I

    2008-05-01

    Full Text Available Abstract Introduction Heterotopic gastric mucosa is described almost everywhere in the gastrointestinal tract, from the oral cavity to the rectum. The occurrence of heterotopic gastric tissue in the gallbladder is rare. A choristoma can be defined as a new growth developing from a displaced anlage not normally present in the anatomical site where it developed. We present an extremely uncommon case of a cyst (choristoma attached to the gallbladder, which contained gastric and intestinal mucosa. Case presentation A 33-year-old woman was hospitalized with clinical symptoms of chronic cholecystitis. The laboratory findings were within the normal range. Abdominal ultrasonography revealed a thickened gallbladder wall and a stone in the cystic duct was suspected. In the course of laparoscopic cholecystectomy, a cyst was visualized in the vicinity of the duct and the gallbladder neck. Microscopic examination of the removed cyst revealed evidence of gastric, duodenal and small-intestinal mucosa. The immunohistochemical study revealed many endocrine cells, which were positive for several endocrine cell markers such as chromogranin, serotonin, gastrin and so on. It can be inferred that the observed cyst had arisen from the foregut early in the development of the gastrointestinal tract. Conclusion The presence of endocrine cells together with epithelial cells supports the hypothesis that these had developed simultaneously, and that the endocrine cells had probably supported the development of the epithelial cells by the release of hormones and growth factors. To the best of the authors' knowledge, this report is the first to report a gastrointestinal cyst choristoma with endocrine cells in the region of the cystic duct and gallbladder.

  10. [Systemic immunological response in children with chronic gingivitis and gastro-intestinal pathology].

    Science.gov (United States)

    Romanenko, E G

    2014-01-01

    Study of the immune system mechanisms in chronic catarrhal gingivitis in children with gastrointestinal pathology was performed in 102 children (49 with chronic gastritis and duodenitis and 53 with no signs of gastrointestinal pathology). Forty-eight children with healthy periodontium constituted control group. Generalized chronic catarrhal gingivitis in children with gastroduodenal pathology is characterized by intense humoral response by simultaneous T-cell immunity suppression. Detection of high serum titers of circulating immune complexes in patients with chronic catarrhal gingivitis suggests a role of immune response in the pathogenesis of periodontal disease increases with concomitant diseases of the upper gastrointestinal tract.

  11. Clinical manifestations and prognostic factors in patients with gastrointestinal stromal tumors

    Institute of Scientific and Technical Information of China (English)

    Shee-Chan Lin; Ming-Jer Huang; Chen-Yuan Zeng; Tzang-In Wang; Zen-Liang Liu; Ray-Kuan Shiay

    2003-01-01

    AIM: To investigate the incidence of CD117-positive immunohistochemical staining in previously diagnosed gastrointestinal (GI) tract stromal tumors (GTST) and to analyze the tumors' clinical manifestations and prognostic factors.METHODS: We retrospectively reviewed 91 cases with a previous diagnosis of GI stromal tumor, leiomyoma, or leiomyosarcoma. Tissue samples were assessed with CD117, CD34, SMA and S100 immunohistochemical staining. Clinical and pathological characteristics were analyzed for prognostic factors.RESULTS: CD117 was positive in 81 (89 %) of 91 tissue samples. There were 59 cases (72.8 %) positive for CD34,13 (16 %) positive for SMA, and 12 (14.8 %) positive for S100. There was no gender difference in patients with CD117-positive GIST. Their mean age was 65 years. There were 44 (54 %) tumors located in the stomach and 29 (36 %)in the small intestine. The most frequent presenting symptoms were abdominal pain and GI bleeding. The mean tumor size was 7.5±5.7 cm. There were 35 cases (43.2 %)with tumors >5 cm. The tumor size correlated significantly with tumor mitotic count and resectability. Tumor size, mitotic count, and resectability correlated significantly with tumor recurrence and survival. There was recurrent disease in 39 % of our patients, and their mean survival after recurrence was 16.6 months. Most recurrences were at the primary site or metastatic to the liver. Twenty-six percent of our patients died of their disease.CONCLUSION: Traditional histologic criteria are not specific enough to diagnose GIST. This diagnosis must be confirmed with CD117 immunohistochemical staining. Prognosis is dependent on tumor size, mitotic count, and resectability.

  12. Extra-articular manifestations of rheumatoid arthritis: risk factors for serious gastrointestinal events.

    OpenAIRE

    Voskuyl, A E; van de Laar, M A; Moens, H J; van der Korst, J K

    1993-01-01

    OBJECTIVES--Serious upper gastrointestinal events are an important threat to patients with arthritis who are treated with non-steroidal anti-inflammatory drugs (NSAIDs). In this study risk factors for serious upper gastrointestinal events are identified in patients with possible or definite rheumatoid arthritis (RA). METHODS--A retrospective analysis of factors that might contribute to the risk of serious upper gastrointestinal events was performed in a cohort of 2315 consecutive patients wit...

  13. Paranasal Manifestations of Early Stage Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Ceren Günel

    2015-04-01

    Full Text Available OBJECTIVE: Chronic lymphocytic leukemia (CLL is the most common adult leukemia. A few studies have been reported about the relationship between CLL and paranasal sinuses. We aimed to investigate the paranasal manifestations of CLL and to determine the expression of nuclear factor-ĸB (NF-kB and tumor necrosis factor (TNF-α in the nasal mucosa in patients with CLL. MATERIALS AND METHODS: This study was a clinical trial that involved 40 patients. Group CLL (n=20 consisted of patients with early-stage CLL who were followed-up at the hematology clinic and who did not receive any treatment. The control group (n=20 consisted of patients who had undergone concha surgery because of nasal obstruction. Paranasal sinus computer tomography scans of all patients were taken, they were scored on the basis of the Lund–Mackay system, and sinusitis findings were recorded. The biopsy material taken from the inferior concha head of all patients was immunohistochemically stained with primary antibodies against NF-kB and TNF-α. RESULTS: There were no statistically significant differences between the two groups with respect to NF-κB (p=0.716 and TNF-α staining scores (p=1.000. The Lund–Mackay scores were significantly higher in the CLL group than in the control group (p=0.004. Fourteen patients had sinusitis at different locations, while the most common diagnosis was maxillary sinusitis (n=8 in the CLL group. CONCLUSION: This study showed that patients with early-stage CLL tend to have rhinosinusitis. However, NF-kB and TNF-α may not have a role in the inflammatory process involving the paranasal sinuses in patients with CLL.

  14. Periorbital edema as initial manifestation of chronic cutaneous lupus erythematosus

    OpenAIRE

    Erras, Samar; Benjilali, Laila; Essaadouni, Lamiaa

    2012-01-01

    Periorbital edema occurs frequently in dermatomyositis, but it has rarely been noted in systemic systemic lupus erythematosus. We describe a patient who developed bilateral periorbital edema and erythema as the sole manifestation of systemic lupus erythematosus.

  15. Immunohistochemical analysis of carbohydrate antigens in chronic inflammatory gastrointestinal diseases.

    Science.gov (United States)

    Kobayashi, Motohiro; Nakayama, Jun

    2010-01-01

    Over the last four decades, immunohistochemistry (IHC) has become an invaluable technique to detect antigens in tissue sections. Compared to Western blotting analysis, IHC is advantageous in determining histological distribution and localization of the antigen. Another advantage, if one can access human formalin-fixed paraffin-embedded (FFPE) blocks of disease tissues, is that IHC makes it possible to analyze diseases retrospectively from archived pathological tissue specimens. In this chapter, we describe protocols used for both conventional and multiple immunostainings using FFPE tissue sections, which have been used for quantitative analysis of high endothelial venule (HEV)-like vessels and lymphocyte subsets attached to HEV-like vessels in our studies of chronic inflammatory gastrointestinal diseases. We also describe in detail a protocol using an L-selectinIgM chimera in situ binding assay on FFPE tissue sections for functional detection of L-selectin ligand carbohydrates expressed on HEV-like vessels. After presenting each protocol, we provide practical examples for its use obtained from our studies.

  16. Use of visible light spectroscopy to diagnose chronic gastrointestinal ischemia and predict response to treatment

    NARCIS (Netherlands)

    Sana, Aria; Moons, Leon M G; Hansen, Bettina E.; Dewint, Pieter; van Noord, Désirée; Mensink, Peter B F; Kuipers, Ernst J.

    2015-01-01

    Background & Aims: Chronic gastrointestinal ischemia (CGI) is more common than previously thought. Visible light spectroscopy (VLS) allows for noninvasive measurements of mucosal capillary hemoglobin oxygen saturation during endoscopy. We evaluated the response of patients with occlusive CGI to trea

  17. Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess the prevalence of extrahepatic manifestations in Bulgarian patients with chronic hepatitis C virus (HCV) infection and identify the clinical and biological manifestations associated with cryoglobulinemia.METHODS: The medical records of 136 chronically infected HCV patients were reviewed to assess the prevalence of extrahepatic manifestations. Association between cryoglobulin-positivity and other manifestations were identified using χ2 and Fisher's exact test. Risk factors for the presence of extrahepatic manifestations were assessed by logistic regression analysis.RESULTS: Seventy six percent (104/136) of the patients had at least one extrahepatic manifestation.Clinical manifestations included fatigue (59.6%),kidney impairment (25.0%), type 2 diabetes (22.8%),paresthesia (19.9%), arthralgia (18.4%), palpable purpura (17.6%), lymphadenopathy (16.2%), pulmonary fibrosis (15.4%), thyroid dysfunction (14.7%), Raynaud's phenomenon (11.8%), B-cell lymphoma (8.8%),sicca syndrome (6.6%), and lichen planus (5.9%).The biological manifestations included cryoglobulin production (37.5%), thrombocytopenia (31.6%), and autoantibodies: anti-nuclear (18.4%), anti-smooth muscle (16.9%), anti-neutrophil cytoplasm (13.2%) and anti-cardiolipin (8.8%). All extrahepatic manifestations showed an association with cryoglobulin-positivity, with the exception of thyroid dysfunction, sicca syndrome,and lichen planus. Risks factors for the presence of extrahepatic manifestations (univariate analysis) were:age ≥ 60 years, female gender, virus transmission by blood transfusions, longstanding infection (≥ 20 years), and extensive liver fibrosis. The most significant risks factors (multivariate analysis) were longstanding infection and extensive liver fibrosis.CONCLUSION: We observed a high prevalence of extrahepatic manifestations in patients with chronic HCV infection. Most of these manifestations were associated with impaired lymphoproliferation and cryoglobulin production

  18. Oral manifestations of a child with chronic vomiting.

    Science.gov (United States)

    Kim, Seong-Oh; Kwak, Ji-Youn; Choi, Byung-Jai; Lee, Jae-Ho

    2005-01-01

    Perimolysis is a type of intrinsic erosion--an irreversible dental demineralization linked to chronic regurgitation--which causes teeth to be more susceptible to dental caries. The purpose of this case report was to study a 35-month-old chronic vomiting child who visited the Department of Pediatric Dentistry in Yonsei Dental Hospital, Seoul, South Korea, for an evaluation of and treatment for the loss of tooth structure of his primary teeth. To prevent further destruction of the teeth and maintain occlusal height, all the posterior teeth were restored with stainless steel crowns and all the anterior teeth were restored with resin veneer crowns after pulpal treatment under general anesthesia. Therefore, when a child suffering from chronic vomiting visits a pediatric dental clinic, it is prudent to: (1) perform all possible dental treatment to control vomiting's adverse influences on the oral structures; and (2) refer the patient to a pediatrician to determine the cause of vomiting. PMID:16294931

  19. Chronic portomesenteic venous thrombosis complicated by a high flow arteriovenous malformation presenting with gastrointestinal bleeding.

    Science.gov (United States)

    Plotnik, Adam N; Hebroni, Frank; McWilliams, Justin

    2016-02-01

    Portomesenteric venous thrombosis is a rare but potentially life-threatening condition. The presenting symptoms of chronic portomesenteric venous thrombosis are often non-specific but may present with variceal bleeding. We present the first reported case of chronic portomesenteric venous thrombosis causing a high flow arteriovenous malformation that resulted in extensive gastrointestinal bleeding. PMID:25871943

  20. Endemic Gastrointestinal Anthrax in 1960s Lebanon: Clinical Manifestations and Surgical Findings

    OpenAIRE

    Kanafani, Zeina A.; Ghossain, Antoine; Sharara, Ala I.; Hatem, Joseph M.; Kanj, Souha S.

    2003-01-01

    Anthrax is an ancient disease caused by the gram-positive Bacillus anthracis; recently, it has gained much attention because of its potential use in biologic warfare. Anthrax infection occurs in three forms: cutaneous, inhalational, and gastrointestinal. The last type results from ingestion of poorly cooked contaminated meat. Intestinal anthrax was widely known in Lebanon in the 1960s, when a series of >100 cases were observed in the Bekaa Valley. We describe some of these cases, introduce th...

  1. Metabolic Manifestations and Complications Associated With Chronic Hepatitis C Virus Infection.

    Science.gov (United States)

    Wong, Robert J; Gish, Robert G

    2016-05-01

    Chronic hepatitis C virus (HCV) infection is associated with many extrahepatic manifestations that contribute to morbidity and mortality. It is especially important to be aware of metabolic manifestations and serious complications that affect other organs and cancer risks. Chronic HCV infection itself contributes to de novo development of insulin resistance and hepatic steatosis, both of which increase the risk of cardiovascular diseases. Through these metabolic pathways (as well as through other hypothesized mechanisms that involve lipid metabolism, systemic inflammatory signals, and endothelial dysfunction), chronic HCV infection also contributes to significant systemic cardiovascular morbidity and mortality. While chronic HCV infection contributes to incident development of metabolic complications, the presence of concurrent metabolic diseases also contributes to disease progression, such as higher risks of hepatocellular carcinoma and progression to advanced fibrosis, among patients with chronic HCV infection. The implications of these observations are particularly important given the rising prevalence of obesity and metabolic syndrome in the United States and worldwide. Furthermore, concurrent nonalcoholic fatty liver disease, either as a result of underlying metabolic syndrome or as a direct result of HCV-induced fatty liver disease, further complicates the management of chronic HCV-infected patients. Greater awareness is needed toward the systemic manifestations of chronic HCV infection, with focused attention on the associated metabolic manifestations and complications. Successful treatment and cure of chronic HCV infection with the currently available, highly effective antiviral therapies will significantly improve long-term outcomes among these patients. It is also important to recognize and address the associated metabolic manifestations and complications to reduce cardiovascular-related morbidity and mortality. PMID:27499712

  2. Chronic endemic regional hydroarsenicism. The manifestations of arsenic poisoning caused by drinking water

    Energy Technology Data Exchange (ETDEWEB)

    Grinspan, D.; Biagini, R.

    1985-01-01

    This report deals with endemic chronic arsenical intoxication (HACRE) observed in several provinces in Argentina. Similar reports come from Chili, Mexico, Brasil, Bolivia, Peru and Japan. HACRE patients show no systemic, symptoms and specific manifestations are palmoplantar keratoderma, multiple cutaneous epitheliomas, mainly Bowen-type and respiratory or digestive carcinomas. The authors emphasize that these specific manifestations of HACRE are worth knowing for their possible social incidence.

  3. [Chronic endemic regional hydroarsenicism. The manifestations of arsenic poisoning caused by drinking water].

    Science.gov (United States)

    Grinspan, D; Biagini, R

    1985-01-01

    This report deals with endemic chronic arsenical intoxication (HACRE) observed in several provinces in Argentina. Similar reports come from Chili, Mexico, Brasil, Bolivia, Peru and Japan. HACRE patients show no systemic, symptoms and specific manifestations are palmoplantar keratoderma, multiple cutaneous epitheliomas, mainly Bowen-type and respiratory or digestive carcinomas. The authors emphasize that these specific manifestations of HACRE are worth knowing for their possible social incidence.

  4. Gastrointestinal manifestations of postnatal cytomegalovirus infection in infants admitted to a neonatal intensive care unit over a five year period.

    Science.gov (United States)

    Cheong, J L Y; Cowan, F M; Modi, N

    2004-07-01

    Sixteen cases of postnatal cytomegalovirus (CMV) infection were identified in a neonatal intensive care unit population over a five year period. Eleven of these infants had gastrointestinal signs at the time of presentation. These ranged from minor and transient (abdominal distension and enteral feed intolerance) to severe and life threatening (protein losing enteropathy, diarrhoea, and hypernatraemic dehydration). An initial diagnosis of necrotising enterocolitis was common, but no infant showed intestinal or hepatic portal pneumatosis. The gestational age of the infants was 24-38 weeks. All had received fresh maternal breast milk. It is suggested that CMV enteritis is added to the spectrum of clinical manifestations of postnatal CMV infection. Signs suggestive of necrotising enterocolitis with atypical features should prompt investigations for CMV infection.

  5. Acute effects of riociguat in borderline or manifest pulmonary hypertension associated with chronic obstructive pulmonary disease

    OpenAIRE

    Ghofrani, Hossein A.; Staehler, Gerd; Grünig, Ekkehard; Halank, Michael; Mitrovic, Veselin; Unger, Sigrun; Mueck, Wolfgang; Frey, Reiner; Grimminger, Friedrich; Ralph T. Schermuly; Behr, Juergen

    2015-01-01

    Riociguat is the first oral soluble guanylate cyclase stimulator shown to improve pulmonary hemodynamics in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (PH). This pilot study assessed the impact of a single dose of riociguat on hemodynamics, gas exchange, and lung function in patients with PH associated with chronic obstructive pulmonary disease (COPD). Adults with COPD-associated borderline or manifest PH (pulmonary vascular resistance > 27...

  6. Part 2: Treatments for Chronic Gastrointestinal Disease and Gut Dysbiosis

    OpenAIRE

    Bull, Matthew J.; Plummer, Nigel T.

    2015-01-01

    Part 1 of this review discussed the connection between the human gut microbiota and health. Manipulation of the intestinal microbiota holds promise as a prospective therapy for gut dysbiosis, ameliorating symptoms of gastrointestinal and systemic diseases and restoring health. The concept of probiotics has existed for more than 100 y, and modern research methods have established sound scientific support for the perceived benefits of probiotic bacteria, which mainly include Lactobacillus and B...

  7. MR imaging of shaken baby syndrome manifested as chronic subdural hematoma

    International Nuclear Information System (INIS)

    Shaken baby syndrome (SBS) is a form of child abuse that can cause significant head injuries, of which subdural hematoma (SDH) is the most common manifestation. We report the MRI findings of chronic SDH in three cases of SBS, involving two-, three- and eight-month-old babies. The SDH signal was mostly low on T1-weighted images and high on T2-weighted images, suggesting chronic SDH. In chronic SDH, a focal high signal on T1-weighted images was also noted, suggesting rebleeding. Contrast-enhanced MRI revealed diffuse dural enhancement

  8. Chronic lymphocytic leukaemia: contemporary conceptions of etiology, pathogenesis and peculiarities of clinical manifestations (review

    Directory of Open Access Journals (Sweden)

    Chesnokova N.P.

    2011-06-01

    Full Text Available The research work presents an analysis of literature review and results of investigations on the problems of etiology, pathogenesis, classification and peculiarities of clinical manifestations of chronic lymphocytic leukaemia. Special attention is paid to both contemporary conceptions of carcinogenesis, reflecting the role of proto-oncogenes activation, an-tioncogenes and apoptosis genes suppression in mechanisms of neoplasia development and «specific mechanisms» of oncogenic transformation induction of B-lymphocytes and the subsequent development of the stages of promotion, progression and marked clinical manifestations of formation. Possibility of further improvement of use of immune phe-notype character and oncomarkers in diagnostics of chronic lymphocytic leukaemia clinical variants and in evaluation of effectiveness of its therapy has been indicated in the article

  9. 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.

  10. Debilitating Chronic Diarrhea Caused by Generalized Gastrointestinal Cytomegalovirus Infection in an Immunocompetent Adult

    Directory of Open Access Journals (Sweden)

    Emmanouil Telakis

    2014-01-01

    Full Text Available Gastrointestinal cytomegalovirus (CMV infection is a common opportunistic infection in immunocompromised patients, especially patients with acquired immunodeficiency syndrome and transplant recipients. In contrast, CMV infection of the gastrointestinal tract is rare in immunocompetent individuals. We report a case of severe, protracted, and debilitating diarrhea caused by generalized CMV infection of the gastrointestinal tract in an elderly woman with no apparent immunosuppression. An extensive diagnostic investigation demonstrated CMV-associated disease affecting both the upper and lower gastrointestinal tracts (esophagus, small intestine, and colon. Such extensive simultaneous involvement of the alimentary tract in an immunocompetent patient is rare and presents a diagnostic and therapeutic challenge. The diagnosis was based on a combination of endoscopic, histopathological, serological, and polymerase chain reaction analysis findings and our patient was successfully treated with intravenous ganciclovir. Our case demonstrates that gastrointestinal CMV infection should be considered in the differential diagnosis of severe chronic diarrhea in immunocompetent patients and that antiviral treatment may be justified in this setting.

  11. The Emerging Extrahepatic Manifestations of Hepatitis C Virus Infection in Chronic Hepatitis and Mixed Cryoglobulinemia

    Directory of Open Access Journals (Sweden)

    Poupak Fallahi

    2008-08-01

    Full Text Available Hepatitis C virus (HCV is known to be responsible for both hepatic and extrahepatic diseases. Mixed cryoglobulinemia, Sjögren syndrome, and chronic polyarthritis are the most documented rheumatologic extrahepatic manifestations of HCV infection. The most frequent and clinically important extrahepatic endocrine manifestations of chronic HCV infection are thyroid disorders and type 2 diabetes mellitus. From a meta-analysis of the literature, a significant association between HCV infection and thyroid autoimmunity and/or hypothyroidism as well as a high prevalence of thyroid cancer have been reported. The pattern of thyroid disorders observed in HCV infected patients is characterized by the presence of elevated circulating anti-thyroid peroxidase antibodies with increased risk of hypothyroidism. Several clinical epidemiologic studies have reported that HCV infection is a risk factor for type 2 diabetes. The type of diabetes manifested by subjects with chronic HCV infection is not of the classical type 2 diabetes; in fact, HCV-related diabetic patients are leaner than the classical diabetic patients, and have a significantly lower LDL-cholesterol, and both systolic and diastolic blood pressure. Furthermore, patients with mixed cryoglobulinemia (mixed cryoglobulinemia and chronic HCV infection with type 2 diabetes have more frequently non-organ-specific-autoantibodies than non-diabetic patients with mixed cryoglobulinemia and those with chronic HCV infection. Based on the above-mentioned findings, it has been hypothesized that diabetes in HCV infection may have an immune-mediated pathogenesis. In patients with chronic HCV infection, we found an increased risk of carotid artery plaque and carotid intima-media thickening. These findings suggested a possible role for chronic hepatitis C in the pathogenesis of carotid artery remodelling. Recently, high prevalence rates of anti-HCV antibodies were shown in patients with hypertrophic cardiomyopathy or

  12. Simotang enhances gastrointestinal motility, motilin and cholecystokinin expression in chronically stressed mice

    Institute of Scientific and Technical Information of China (English)

    Guang-Xian Cai; Bai-Yan Liu; Jian Yi; Xue-Mei Chen; Fu-Ling Liu

    2011-01-01

    AIM: To investigate the effect of Simotang (Decoction of Four Powered Drugs) on gastrointestinal motility, motilin and cholecystokinin expression in chronically stressed mice. METHODS: Forty mice were randomly divided into control group, stress group (model group), mosapride group and Simotang group, 10 in each group. A variety of unpredictable stimulations were used to induce chronic stress in mice. Then, the mice were treated with distilled water, mosapride or Simotang for 7 d. Gastric emptying and intestinal propulsion function were detected. Serum level of motilin was measured by enzyme-linked immunosorbent assay. Expression of cholecystokinin (CCK) in intestine, spinal cord and brain of mice was detected by immunohistochemistry and semi-quantitative reverse transcription polymerase chain reaction, respectively. RESULTS: Simotang improved the gastric emptying and intestinal propulsion in chronically stressed mice. Furthermore, the serum motilin level was significantly higher and the expression levels of CCK-positive cells and genes were significantly lower in intestine, spinal cord and brain of Simotang group than in those of model group (P < 0.05). No significant difference was found in serum motilin level and expression levels of CCK-positive cells and genes between the mosapride and Simotang groups. CONCLUSION: Simotang enhances the gastrointestinal motility in chronically stressed mice by regulating the serum motilin level and the expression of cholecystokinin.

  13. Microbiota alterations in acute and chronic gastrointestinal inflammation of cats and dogs.

    Science.gov (United States)

    Honneffer, Julia B; Minamoto, Yasushi; Suchodolski, Jan S

    2014-11-28

    The intestinal microbiota is the collection of the living microorganisms (bacteria, fungi, protozoa, and viruses) inhabiting the gastrointestinal tract. Novel bacterial identification approaches have revealed that the gastrointestinal microbiota of dogs and cats is, similarly to humans, a highly complex ecosystem. Studies in dogs and cats have demonstrated that acute and chronic gastrointestinal diseases, including inflammatory bowel disease (IBD), are associated with alterations in the small intestinal and fecal microbial communities. Of interest is that these alterations are generally similar to the dysbiosis observed in humans with IBD or animal models of intestinal inflammation, suggesting that microbial responses to inflammatory conditions of the gut are conserved across mammalian host types. Studies have also revealed possible underlying susceptibilities in the innate immune system of dogs and cats with IBD, which further demonstrate the intricate relationship between gut microbiota and host health. Commonly identified microbiome changes in IBD are decreases in bacterial groups within the phyla Firmicutes and Bacteroidetes, and increases within Proteobacteia. Furthermore, a reduction in the diversity of Clostridium clusters XIVa and IV (i.e., Lachnospiraceae and Clostridium coccoides subgroups) are associated with IBD, suggesting that these bacterial groups may play an important role in maintenance of gastrointestinal health. Future studies are warranted to evaluate the functional changes associated with intestinal dysbiosis in dogs and cats.

  14. 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.

  15. 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

  16. Benign and malignant hematological manifestations of chronic Hepatitis C virus infection

    Directory of Open Access Journals (Sweden)

    Shiksha Kedia

    2014-01-01

    Full Text Available Chronic hepatitis C virus (HCV infection, that affects 3% of world′s population, is associated with several hematological manifestations mainly benign cytopenias, coagulopathy and lymphoproliferative diseases. Immune or non-immune-mediated thrombocytopenia is a major challenge in chronic HCV infected patients especially in the setting of an advanced liver disease, with average prevalence of nearly 24%. Although several treatment modalities such as steroids, intravenous immunoglobulin, splenectomy and immunosuppresants have been tried with some success, their efficacy is not impressive and can result in an increase in viral load or other thrombotic complications. Even though a recent phase 2 study has shown promising role of a platelet growth factor, eltrombopag, in boosting platelets counts prior to antiviral treatment, its use in pre-operative setting had unexpected complications. Unlike thrombocytopenia, anemia and neutropenia are more frequently seen in treated patients and are often the result of antiviral therapy. HCV infection also pre-disposes to lymphoproliferative diseases, mainly non-Hodking′s lymphomas, likely as a result of chronic antigenic stimulation and mutation of several genes involved in carcinogenesis. Understanding of the role of HCV infection in these conditions has therapeutic implications. Whereas antiviral therapy has shown therapeutic role in HCV-associated indolent lymphomas, monitoring of hepatic function and viral load is important in the management of diffuse large B-cell lymphoma in HCV-infected patients. Although our knowledge about the HCV infection and hematological manifestations has substantially grown in last few decades, further studies are important to advance our therapeutic approach.

  17. MSCT manifestations with pathologic correlation of abdominal gastrointestinal tract and mesenteric tumor and tumor-like lesions in children: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Liu Yue, E-mail: liuyue20036@yahoo.com.c [Department of Radiology, Beijing Children' s Hospital Affiliated to Capital Medical University. 56 Nanlishi Road, West District, Beijing 100045 (China); Peng Yun, E-mail: ppengyun@yahoo.co [Department of Radiology, Beijing Children' s Hospital Affiliated to Capital Medical University. 56 Nanlishi Road, West District, Beijing 100045 (China); Li Jianying; Zeng Jinjin; Sun Guoqiang [Department of Radiology, Beijing Children' s Hospital Affiliated to Capital Medical University. 56 Nanlishi Road, West District, Beijing 100045 (China); Gao Peiyi, E-mail: cjr.gaopeiyi@vip.163.co [Department of Neuroradiology, Beijing Tian Tan Hospital Affiliated to Capital Medical University. 6 Tiantanxili Road, Chongwen District, Beijing 100050 (China)

    2010-09-15

    To study the multi-slice spiral computed tomography (MSCT) manifestations of gastrointestinal tract (GIT) and mesenteric tumor and tumor-like lesions in children and correlation with pathologic findings. 22 patients (17 male, 5 female; age ranged from 3 days to 11 years; with mean of 4.2 years) were screened out by ultrasonography (US) at first, then were performed with abdominal non-enhanced CT (NECT) and contrast-enhanced CT (CECT) scans. All CT images were evaluated independently by two radiologists and a consensus was reached regarding the morphologic features for lesions such as size, solid/cyst, unilocular/multilocular and thin/thick wall characteristics. The 26 lesions were categorized into two groups based on CT characteristics of lesions' nature, group 1 with the prominent cystic lesions, group 2 with prominent solid lesions. Group 1 was further divided into two subgroups: group 1A for the cystic lesions with thin walls, and group 1B for the cystic lesions with thick walls. In group 1A, 7 lesions were unilocular cysts (6 lymphangioma, 1 ileum mesenteric cyst) and 5 were multilocular cysts with internal septation (4 lymphangioma, 1 greater omental cyst). In group 1B, 10 lesions in 7 patients were unilocular without internal septation, which had two kinds of shape-cystic and tubular, their histopathological types were all enteric duplication cyst (10 segments, with two patients with 2 or 3 segments each); In group 2, all lesions had solid mass (2 gastrointestinal stromal tumors and 2 enteric non-Hodgkin's lymphoma). The majority of gastrointestinal tumors and tumor-like lesions are cystic and benign. MSCT manifestations of cystic/solid and thin/thick wall may be great helpful for differentiating different types of GIT and mesenteric lesions. MSCT manifestations have close correlations with their topographic sites and histopathologic findings.

  18. Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults.

    Science.gov (United States)

    Angulo, Javier; El Assar, Mariam; Rodríguez-Mañas, Leocadio

    2016-08-01

    Frailty is a functional status that precedes disability and is characterized by decreased functional reserve and increased vulnerability. In addition to disability, the frailty phenotype predicts falls, institutionalization, hospitalization and mortality. Frailty is the consequence of the interaction between the aging process and some chronic diseases and conditions that compromise functional systems and finally produce sarcopenia. Many of the clinical manifestations of frailty are explained by sarcopenia which is closely related to poor physical performance. Reduced regenerative capacity, malperfusion, oxidative stress, mitochondrial dysfunction and inflammation compose the sarcopenic skeletal muscle alterations associated to the frailty phenotype. Inflammation appears as a common determinant for chronic diseases, sarcopenia and frailty. The strategies to prevent the frailty phenotype include an adequate amount of physical activity and exercise as well as pharmacological interventions such as myostatin inhibitors and specific androgen receptor modulators. Cell response to stress pathways such as Nrf2, sirtuins and klotho could be considered as future therapeutic interventions for the management of frailty phenotype and aging-related chronic diseases. PMID:27370407

  19. Cutaneous Manifestations in Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Simona Roxana Georgescu

    2015-10-01

    Full Text Available Inflammatory bowel diseases have a high frequency in Europe. They are chronic disorders that evolve with relapses and remissions. Clinical features include the signs of underlying inflammatory bowel disease and also signs of extraintestinal manifestations. Cutaneous disorders are the most common extraintestinal manifestations associated with inflammatory bowel diseases, which can be dependent on or independent of gastrointestinal disease activity. The main cutaneous disorders are erythema nodosum and pyodermagangrenosum. The pathogenic mechanisms are not fully understood but it seems that related mechanisms are involved in the development of inflammatory bowel diseases and extraintestinal manifestations. Treatment should be aimed at both the cutaneous manifestations and the bowel inflammation

  20. Cutaneous Manifestations in Inflammatory Bowel Diseases

    OpenAIRE

    Simona Roxana Georgescu; Cristina Iulia Mitran; Madalina Irina Mitran; Monica Costescu; Vasile Benea; Maria Isabela Sarbu; Mircea Tampa

    2015-01-01

    Inflammatory bowel diseases have a high frequency in Europe. They are chronic disorders that evolve with relapses and remissions. Clinical features include the signs of underlying inflammatory bowel disease and also signs of extraintestinal manifestations. Cutaneous disorders are the most common extraintestinal manifestations associated with inflammatory bowel diseases, which can be dependent on or independent of gastrointestinal disease activity. The main cutaneous disorders are erythema nod...

  1. Chronic Stanford type A aortic dissection manifesting as systemic inflammatory disorder

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    Yana Kogan

    2016-05-01

    Full Text Available Typical presentation of type A aortic dissection usually encompasses severe acute chest pain, frequently radiating to the upper back, which is seen in more than 80% of the patients, while isolated back or abdominal pain have been repeatedly reported as the first manifestation of the disease as well. Occasionally, dyspnea due to acute aortic regurgitation, syncope, or stroke, secondary to obstruction of major cerebral vessels, have also been described at presentation of type A aortic dissection. Presentation of aortic dissection as a prolonged systemic illness with a number of nonspecific clinical and laboratory findings, such as low-grade fever, fatigue, malaise, weight loss, anemia, elevated acute phase response laboratory parameters, and absence of any of typical clinical features of the dissection syndrome has been only rarely reported. We describe a patient with type A chronic aortic dissection, manifesting as a systemic inflammatory disorder in the absence of acute chest syndrome. The diagnosis was made accidentally by computed tomography, ordered in the course of the regular work up. The patient underwent emergent surgery with resection and grafting of the dissected aorta. Pathological investigation demonstrated intense acute inflammation with neutrophilic infiltration in the vicinity of the intramural hemorrhage and necrosis, as well as granulation tissue with new vessels formation and collagen deposition in the outer media. The possible pathogenic mechanisms of the phenomenon are discussed. [Int J Res Med Sci 2016; 4(5.000: 1768-1771

  2. Immunophenotyping in post-giardiasis functional gastrointestinal disease and chronic fatigue syndrome

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    Hanevik Kurt

    2012-10-01

    Full Text Available Abstract Background A Giardia outbreak was associated with development of post-infectious functional gastrointestinal disorders (PI-FGID and chronic fatigue syndrome (PI-CFS. Markers of immune dysfunction have given conflicting results in CFS and FGID patient populations. The aim of this study was to evaluate a wide selection of markers of immune dysfunction in these two co-occurring post-infectious syndromes. Methods 48 patients, reporting chronic fatigue in a questionnaire study, were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS (n=19 and idiopathic chronic fatigue (n=5 and Rome II criteria for FGIDs (n=54. 22 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Results In peripheral blood we found significantly higher CD8 T-cell levels in PI-FGID, and significantly lower NK-cell levels in PI-CFS patients. Severity of abdominal and fatigue symptoms correlated negatively with NK-cell levels. A tendency towards lower T-cell CD26 expression in FGID was seen. Conclusion Patients with PI-CFS and/or PI-FGID 5 years after Giardia lamblia infection showed alterations in NK-cell and CD8-cell populations suggesting a possible immunological abnormality in these conditions. We found no significant changes in other markers examined in this well-defined group of PI-CFS and PI-FGID elicited by a gastrointestinal infection. Controlling for co-morbid conditions is important in evaluation of CFS-biomarkers.

  3. Successful Use of Plasma Exchange in the Treatment of Corticosteroid-Refractory Eosinophilic Granulomatosis with Polyangiitis Associated with Gastrointestinal Manifestations

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    Kohei Tsujimoto

    2016-01-01

    Full Text Available We describe the case of a 33-year-old woman having corticosteroid-refractory eosinophilic granulomatosis with polyangiitis (EGPA who presented with abdominal pain and responded dramatically to plasma exchange. Eosinophilia, asthma history, neuropathy, pulmonary infiltrates, and paranasal sinus abnormalities confirmed the diagnosis of EGPA. Treatment was initiated with 1 g/day of methylprednisolone pulse therapy for 3 days followed by 60 mg/day of intravenous prednisolone without relieving abdominal pain. Then, plasma exchange was performed thrice. Abdominal pain disappeared after the first plasma exchange. Indication of plasma exchange for EGPA remains controversial; however, it may represent a valid option in cases with gastrointestinal involvement.

  4. Non-nutritional effects of food: an underutilized and understudied therapeutic tool in chronic gastrointestinal diseases.

    Science.gov (United States)

    Gibson, Peter R; Muir, Jane G

    2013-12-01

    The use of diet has traditionally been used to improve the nutrition of patients. However, diet also can be utilized to modify disease processes and manage symptoms independently of its nutritional role. There are few chronic gastrointestinal conditions where dietary modification is utilized therapeutically and backed by a high degree of evidence. This is not due to a lack of ideas but is more likely to lie in the difficulties associated with translating those ideas into evidence-based practice. Long lead-in times and low incidence hinders interventional studies of prevention for many conditions. The design and execution of dietary clinical trials is challenging and funding them even more so. The knowledge base of doctors in nutrition and food composition is often poor, and attitudes toward the success of and adherence to dietary therapies create additional problems. However, ideas can be successfully translated into evidence-based practice, as exemplified but the low fermentable, oligo-, di-, and mono-saccharides and polyols (FODMAP) (poorly-absorbed short-chain carbohydrates) diet for patients with functional bowel symptoms. Showing efficacy is, however, insufficient for non-nutritional dietary manipulations. Adverse effects, such as nutritional adequacy of the diet and effect on pathogenesis of other diseases, must also be carefully addressed. The physiological principles upon which the diet is based should be matched to the physiology associated with the condition being targeted, as it can be hazardous to extrapolate findings in healthy persons. There is a need for greater attention to the evaluation of dietary therapies for many chronic gastrointestinal disorders. PMID:24251702

  5. Extraintestinal manifestations in Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Isene, Rune; Bernklev, Tomm; Høie, Ole;

    2015-01-01

    BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal manifest......BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal......, skin, and liver) manifestations: 20.1% versus 10.4% (p colitis compared to proctitis in UC increased the risk of EIM. CONCLUSION: In a European inception cohort, EIMs in IBD...

  6. Psychiatric manifestation of chronic subdural hematoma: The unfolding of mystery in a homeless patient

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    Sujita Kumar Kar

    2015-01-01

    Full Text Available The clinical manifestation of chronic subdural hematoma is not limited to neurological deficits or cognitive impairment. It may present with behavioral abnormalities. When the behavioral abnormalities present without obvious neurological deficits and in the absence of trauma, it leads to misdiagnosis. A trivial trauma may cause intracranial bleed that is either missed or ignored in the clinical history. This case report highlights the clinical picture of a homeless patient who presented with withdrawn and disorganized behavior, apathy and poverty of speech in the absence of any neurological deficit. His clinical presentation led to a possibility of psychosis and he was started on antipsychotics. He had developed extrapyramidal side effects in low dose of antipsychotic without any clinical benefit in his clinical picture. Neuroimaging done to rule out any possible organicity-revealed bilateral subdural hematoma, which was later evacuated by neurosurgical intervention in multiple settings and the patient had improved. This case report unfolds the mystery behind the psychotic presentation in a homeless adult.

  7. From past sailors' eras to the present day: scurvy as a surprising manifestation of an uncommon gastrointestinal disease.

    Science.gov (United States)

    Branquinho, Diogo Ferreira; Pinto-Gouveia, Miguel; Mendes, Sofia; Sofia, Carlos

    2015-01-01

    A 45-year-old man presented with follicular exanthema in his lower limbs, alternating bowel habits and significant weight loss. His medical history included seronegative arthritis, bipolar disease and an inconclusive diagnostic laparoscopy. Diagnostic work up revealed microcytic anaemia and multivitamin deficiency. Skin biopsy of the exanthema suggested scurvy. Owing to these signs of malabsorption, upper endoscopy with duodenal biopsies was performed, exhibiting villous atrophy and extensive periodic acid-Schiff-positive material in the lamina propria, therefore diagnosing Whipple's disease (WD). After starting treatment with ceftriaxone and co-trimoxazole, an impressive recovery was noted, as the wide spectrum of malabsorption signs quickly disappeared. After a year of antibiotics, articular and cutaneous manifestations improved, allowing the patient to stop taking corticosteroids and antidepressants. This truly unusual presentation reflects the multisystemic nature of WD, often leading to misdiagnosis of other entities. Scurvy is a rare finding in developed countries, but its presence should raise suspicion for small bowel disease. PMID:26376699

  8. Acute and chronic manifestations of Ammi majus induced photosensitisation in ducks.

    Science.gov (United States)

    Egyed, M N; Shlosberg, A; Eilat, A; Malkinson, M

    1975-09-13

    The acute and chronic symptoms seen in ducks following Ammi majus induced photosensitisation are described. The acute changes were inflammatory in nature whereas the chronic changes included severe deformities of the beak and footwebs, mydriasis and eccentric location of the pupil.

  9. Disseminated aspergillosis as the herald manifestation of chronic granulomatous disease in an adult patient.

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    Ilad Alavi Darazam

    2014-02-01

    Full Text Available Chronic granulomatous disease is an inherited defect in intracellular killing of ingested microorganisms characterized by recurrent life threatening bacterial and fungal infections including invasive aspergillosis in early childhood. We report a disseminated aspergillosis as the representative of adult onset chronic granulomatous disease without previous infection, with dramatic response to combination of antifungal and interferon therapy.

  10. Extrahepatic manifestations of chronic hepatitis C virus infection:297 cases from a tertiary medical center in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    Cheng Zhaojing; Zhou Baotong; Shi Xiaochun; Zhang Yao; Zhang Lifan; Chen Limeng; Liu Xiaoqing

    2014-01-01

    Background Chronic hepatitis C virus (HCV) infection can affect multiple organ systems and cause a variety of extrahepatic manifestations (EMs).We sought to assess the constituent ratio of EMs in Chinese patients with chronic HCV infection and identify the clinical and biological factors associated with EM.Methods The medical records of 297 patients with chronic HCV infection were analyzed and demographic and epidemiological information was collected.The diagnosis of chronic HCV infection was based on positive anti-HCV combined with a positive HCV-RNA or at least two times of elevated aminotransferases attributable to HCV infection.Patients with HBV and/or HIV coinfection,autoimmune hepatitis,and history of alcohol abuse were excluded.Results Sixty-two percent (184/297) of the patients had at least one EM,including fatigue (29.4%),type 2 diabetes mellitus (28.2%),renal involvement (12.5%),lymphadenopathy (9.6%),fever (9.4%),thyroid dysfunction (8.1%),and arthralgia (7.4%).Neuropathy,sicca syndrome,B-cell lymphoma,Raynaud's phenomenon,and lichen planus were rare.The mean age of patients with EM was older compared with those without EM.Conclusions EMs were common in Chinese patients with chronic HCV infection,particularly fatigue,type 2 diabetes,renal impairment,lymphadenophy,fever,and thyroid dysfunction.Older age was associated with EMs.

  11. Chronic Sclerosing Sialadenitis (Kuttner Tumor) in the sublingual gland: unusual manifestation related to partial edentulism and chronic masticatory trauma.

    OpenAIRE

    Pinheiro, Tiago Novaes

    2011-01-01

    Chronic sclerosing sialadenitis or Küttner tumor is an unusual chronic inflammatory disease of the salivary gland that mimics a malignant neoplasm clinically because of presentation as a hard mass. The diagnosis can only be made histologically and is an underrecognized entity. Recent studies have shown important features that characterizes the disease mainly as an autoimmune reaction. The aim of this work is to report a case of a 40-year-old man, presenting with a three-year histo...

  12. Renal embolism as a primary manifestation of Streptococcus dysgalactiae subspecies equisimilis endocarditis in a patient with chronic aortic dissection.

    Science.gov (United States)

    Ishimaru, Naoto; Kinami, Saori; Ohnishi, Hisashi; Takagi, Asuka; Kawamoto, Megumi; Doukuni, Ryota; Umezawa, Kanoko; Oozone, Sachiko; Yoshimura, Sho; Sakamoto, Susumu

    2015-06-01

    We report a case of renal embolism as an initial manifestation of Streptococcus dysgalactiae subspecies equisimilis (SDSE) endocarditis in a patient with chronic aortic dissection. A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain. The endocarditis affected the native aortic valve and was complicated by a renal embolism. Blood culture results were positive for SDSE. Intravenous penicillin resulted in satisfactory clinical and echocardiographic recovery. PMID:26110298

  13. Congenital Insensitivity to Pain with Anhidrosis (CIPA Manifested with Chronic Osteomyelitis; A Case Report

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    Fatih Kucukdurmaz

    2014-03-01

    Full Text Available      Chronic osteomyelitis is a very rare entity among children. Also congenital insensitivity to pain with anhidrosis (CIPA is a very rare autosomal-recessive disease  of the nervous system which is one of the hereditary sensory and autonomic neuropathies (HSAN. Loss of pain, fever due to anhidrosis, recurrent fractures, chronic osteomyelitis, mental retardation, self mutilation, wound ulcers can be seen. We present a 10-year-old boy with loss of generalized pain sensation, chronic osteomyelitis on his right distal femur, bilateral corneal opacities, and decreased mental capacity.

  14. Oral manifestations of chronic disseminated langerhans cell histiocytosis: a case report

    OpenAIRE

    Namdar Pekiner, Filiz; BORAHAN, M.Oğuz; ÖZBAYRAK, Semih; Alatlı, Canan; Kızılyel, Gizem

    2012-01-01

    The term histiocytosis X was introduced as a collective designation for a spectrum of clinopathologic disorders characterized by proliferation of histiocyte-like cells. The distinctive histiocytic cells present in this lesion have been identified as Langerhans cells, and the condition is now designated as Langerhans cell histiocytosis. Chronic disseminated langerhans cell histiocytosis is a disease involving bone, skin, and viscera (Hand-Schüller-Christian disease). The often-cited Chronic di...

  15. 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

  16. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child

    Science.gov (United States)

    Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    ABSTRACT% Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219. PMID:25709306

  17. Clinical manifestations of chronic viral hepatitis С in children suffering for a one-year period

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    Churbakova О.V.

    2012-09-01

    Full Text Available Aim: the topical issue in medicine is currently considered to be the morbidity of chronic hepatitis in children. Material and methods. The article deals with the course of chronic hepatitis С in children with the light form of disease. The disease course has been from 6 months till 1 year. Results. According to the data of epidemiological anamneses (the analysis of the out-patient cards, previous discharges the possible way and prospective date of infection of majority of children and adolescents have been revealed. 68 children with Chronic Viral Hepatitis С at the age of from 7 months till 18 years have been under the study. Conclusion. General clinical, biochemical and instrumental methods of investigation have been carried out.

  18. “Ninjinto” (Ginseng Decoction), a Traditional Japanese Herbal Medicine, Improves Gastrointestinal Symptoms and Immune Competence in Patients with Chronic Intestinal Failure

    OpenAIRE

    Shuichiro Uehara; Keiko Ogawa; Junsuke Arimitsu; Hiroomi Okuyama

    2015-01-01

    Background. Treating functional gastrointestinal disorders is extremely difficult. We herein report the effect of the oral administration of Ninjinto (NJT, ginseng decoction), a traditional Japanese Kampo medicine, on chronic intestinal failure. Patients and Methods. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. The primary diseases included chronic intestinal pseudoobstruction (CIPO: n = 4), short bowel syndrome (SBS: n = 2), and intestinal atr...

  19. Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse

    Institute of Scientific and Technical Information of China (English)

    Siva P Sontineni; Sanjay Chaudhary; Vijaya Sontineni; Stephen J Lanspa

    2009-01-01

    Cannabis is a common drug of abuse that is associated with various long-term and short-term adverse effects.The nature of its association with vomiting after chronic abuse is obscure and is underrecognised by clinicians. In some patients this vomiting can take on a pattern similar to cyclic vomiting syndrome with a peculiar compulsive hot bathing pattern, which relieves intense feelings of nausea and accompanying symptoms. In this case report, we describe a twentytwo year-old-male with a history of chronic cannabis abuse presenting with recurrent vomiting, intense nausea and abdominal pain. In addition, the patient reported that the hot baths improved his symptoms during these episodes. Abstinence from cannabis led to resolution of the vomiting symptoms and abdominal pain. We conclude that in the setting of chronic cannabis abuse, patients presenting with chronic severe nausea and vomiting that can sometimes be accompanied by abdominal pain and compulsive hot bathing behaviour, in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.

  20. Polymorphic sites at the immunoregulatory CTLA-4 gene are associated with chronic chagas disease and its clinical manifestations.

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    Fabrício C Dias

    Full Text Available BACKGROUND: Chagas disease affects approximately 10 million people mainly in Latin America. The immune regulation by the host seems to be an essential factor for disease evolution, and immune system inhibitory molecules such as CTLA-4 and PD-1 favor the maintenance of peripheral tolerance. Considering that polymorphisms at the immunoregulatory CTLA-4 and PDCD1 genes may alter their inhibitory function, we investigated the association of alleles, genotypes and haplotypes of polymorphic sites observed at the CTLA-4 and PDCD1 genes with different clinical manifestations of chronic Chagas disease (indeterminate, cardiac, digestive and mixed. METHODS: The polymorphisms at the CTLA-4 (-1722T/C, -318C/T and +49A/G and PDCD1 (PD-1.3G/A genes were typed using TaqMan methodology in 277 chronic Chagas disease patients classified into four groups, according to clinical characteristics, and 326 non-infected controls. RESULTS: Our results showed that CTLA-4 -1722CC genotype (22%, -1722C allele (27% and CTLA-4 TCG (8.6%, TCA (26% and CCA (15% haplotypes were strongly associated with the indeterminate form, while the CTLA-4-318CT genotype (82% and CTLA-4-318T allele (47% were found mainly in patients with the mixed form of the disease. The CTLA-4 TCG haplotype (10.2% was associated with the digestive form. On the other hand, the PD-1.3G/A polymorphism was not associated with chronic Chagas disease and its clinical manifestations. CONCLUSIONS: Here, we showed that alleles, genotypes and haplotypes reported to increase the expression of the regulatory molecule CTLA-4 were associated with the indeterminate form of the disease. Taken together, our data support the idea that polymorphic sites at immunoregulatory genes may influence the development of Chagas disease variants.

  1. Rare Neurological Manifestation of Celiac Disease

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    Uzma Rani

    2015-06-01

    Full Text Available Celiac disease (CD is an immune-mediated disease characterized by permanent gastrointestinal tract sensitivity to gluten in genetically predisposed individuals. It has varied clinical manifestations, ranging from gastrointestinal to extraintestinal, including neurological, skin, reproductive and psychiatric symptoms, which makes its diagnosis difficult and challenging. Known neurological manifestations of CD include epilepsy with or without occipital calcification, attention deficit hyperactivity disorder and ataxia, headache, neuropathies and behavior disorders. We present the case of a 14-year-old female with headaches and blurred vision for 1 year; she was noted to have papilledema on ophthalmic examination with increased cerebrospinal fluid opening pressure on lumber puncture and was diagnosed as a case of pseudotumor cerebri (PTC. Meanwhile her workup for chronic constipation revealed elevated tissue transglutaminase IgA and antiendomysial IgA antibodies. Upper gastrointestinal endoscopy with duodenal biopsy confirmed the diagnosis of CD. The patient was started on a gluten-free diet, leading to resolution of not only gastrointestinal symptoms but also to almost complete resolution of symptoms of PTC. This report describes the correlation of CD and PTC as its neurological manifestation.

  2. Multiple Gastrointestinal Complications of Crack Cocaine Abuse

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    Neal Carlin

    2014-01-01

    Full Text Available Cocaine and its alkaloid free base “crack-cocaine” have long since been substances of abuse. Drug abuse of cocaine via oral, inhalation, intravenous, and intranasal intake has famously been associated with a number of medical complications. Intestinal ischemia and perforation remain the most common manifestations of cocaine associated gastrointestinal disease and have historically been associated with oral intake of cocaine. Here we find a rare case of two relatively uncommon gastrointestinal complications of hemorrhage and pancreatitis presenting within a single admission in a chronic crack cocaine abuser.

  3. Digestive manifestations of parathyroid disorders

    Institute of Scientific and Technical Information of China (English)

    Bassam Abboud; Ronald Daher; Joe Boujaoude

    2011-01-01

    The parathyroid glands are the main regulator of plasma calcium and have a direct influence on the digestive tract. Parathyroid disturbances often result in unknown long-standing symptoms. The main manifestation of hypoparathyroidism is steatorrhea due to a deficit in exocrine pancreas secretion. The association with celiac sprue may contribute to malabsorption. Hyperparathyroidism causes smooth-muscle atony, with upper and lower gastrointestinal symptoms such as nausea, heartburn and constipation. Hyperparathyroidism and peptic ulcer were strongly linked before the advent of proton pump inhibitors. Nowadays, this association remains likely only in the particular context of multiple endocrine neoplasia type 1/Zollinger-Ellison syndrome. In contrast to chronic pancreatitis, acute pancreatitis due to primary hyperparathyroidism is one of the most studied topics. The causative effect of high calcium level is confirmed and the distinction from secondary hyperparathyroidism is mandatory. The digestive manifestations of parathyroid malfunction are often overlooked and serum calcium level must be included in the routine workup for abdominal symptoms.

  4. Bilateral quadriceps tendon rupture as the presenting manifestation of chronic kidney disease

    OpenAIRE

    Wani, N A; Malla, H. A.; Kosar, T; Dar, I. M.

    2011-01-01

    Bilateral painful knees with loss of extension in a patient with chronic kidney disease (CKD) may be due to spontaneous quadriceps tendon rupture. This rare complication is usually seen in patients on long term dialysis. We present a case of bilateral spontaneous quadriceps tendon rupture demonstrated by magnetic resonance imaging in a 20-year-old woman who on evaluation was found to have CKD.

  5. Extraintestinal manifestations and complications in inflammatory bowel diseases

    Institute of Scientific and Technical Information of China (English)

    Katja S Rothfuss; Eduard F Stange; Klaus R Herrlinger

    2006-01-01

    Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that often involve organs other than those of the gastrointestinal tract. These nonintestinal affections are termed extraintestinal symptoms. Differentiating the true extraintestinal manifestations of inflammatory bowel diseases from secondary extraintestinal complications, caused by malnutrition, chronic inflammation or side effects of therapy, may be difficult. This review concentrates on frequency, clinical presentation and therapeutic implications of extraintestinal symptoms in inflammatory bowel diseases. If possible, extraintestinal manifestations are differentiated from extraintestinal complications. Special attention is given to the more recently described sites of involvement; I.e. Thromboembolic events, osteoporosis, pulmonary involvement and affection of the central nervous system.

  6. The role of chronic inflammation in the development of gastrointestinal cancers: reviewing cancer prevention with natural anti-inflammatory intervention.

    Science.gov (United States)

    Lee, Ho-Jae; Park, Jong-Min; Han, Young Min; Gil, Hong Kwon; Kim, Jinhyung; Chang, Ji Young; Jeong, Migyeong; Go, Eun-Jin; Hahm, Ki Baik

    2016-01-01

    Inflammatory mediators alter the local environment of tumors, known as the tumor microenvironment. Mechanistically, chronic inflammation induces DNA damage, but understanding this hazard may help in the search for new chemopreventive agents for gastrointestinal (GI) cancer which attenuate inflammation. In the clinic, GI cancer still remains a major cause of cancer-associated mortality, chemoprevention with anti-inflammatory agents is thought to be a realistic approach to reduce GI cancer. Proton pump inhibitors, monoclonal antibodies targeting tumor necrosis factor-alpha, anti-sense targeted smad7 and non-steroidal anti-inflammatory agents have been investigated for their potential to prevent inflammation-based GI cancer. Besides these, a wide variety of natural products have also shown potential for the prevention of GI cancer. In this review, the authors will provide insights to explain the mechanistic connection between inflammation and GI cancer, as well as describe a feasible cancer prevention strategy based on anti-inflammatory treatments.

  7. Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract

    DEFF Research Database (Denmark)

    Keller, Jutta; Beglinger, Christoph; Holst, Jens Juul;

    2009-01-01

    . Thirteen healthy subjects (CON), 13 patients with Crohn's disease (CD), 10 with ulcerative colitis (UC), and 7 with diverticulitis (DIV) underwent a standardized (13)C-octanoic acid gastric emptying breath test. Plasma glucose, CCK, peptide YY, and glucagon-like peptide-1 (GLP-1) were measured periodically......It is unclear why patients with inflammation of the distal bowel complain of symptoms referable to the upper gastrointestinal tract, specifically to gastric emptying (GE) disturbances. Thus we aimed to determine occurrence and putative pathomechanisms of gastric motor disorders in such patients...

  8. 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.

  9. Mechanisms of Gastric Emptying Disturbances in Chronic and Acute Inflammation of the Distal Gastrointestinal Tract

    DEFF Research Database (Denmark)

    Keller, Jutta; Beglinger, Christoph; Holst, Jens Juul;

    2009-01-01

    Objective: It is unclear why patients with inflammation of the distal bowel complain of symptoms referable to the upper gastrointestinal tract, specifically to gastric emptying (GE) disturbances. Thus, we aimed to determine occurrence and putative pathomechanisms of gastric motor disorders...... (25.1[5.2] vs. 33.5[13.0] pmol/l, p=0.046) but markedly decreased in DIV (9.6[5.2] pmol/l, pdisturbances are most pronounced in CD and might partly be caused by excessive CCK release. In DIV there might...... be a pathophysiological link between decreased GLP-1 release, postprandial hyperglycemia and delayed GE. These explorative data encourage further studies in larger patient groups. Key words: inflammatory bowel disease, diverticulitis, motility, hormonal regulation....

  10. IDENTIFICATION OF UNDERLYING CAUSES OF CHRONIC UNSPECIFIC UPPER GASTROINTESTINAL-RELATED SYMPTOMS IN CHILDREN, A PILOT STUDY.

    Science.gov (United States)

    Fouad, Hanan M; Abdulla, Nour A; El Naghy, Suzan; Hassan, Ehsan H; Abd El-Hamid, Amal

    2016-04-01

    Upper gastrointestinal tract (GIT) symptoms are not disease specific and of limited value in the differentiation of GIT disorders. The present study aimed to determine the etiology of chronic unspecific symptoms in children and to test the need for upper endoscopy in diagnosis. This is a prospective study for 30 Egyptian children presented with chronic upper GIT symptoms for at least 2 months. History regarding severity and frequency of GIT symptoms were asked for. Children with known disorder that explains presenting symptoms were excluded. Upper GIT endoscopy wa performed and 5 biopsies were obtained for pathological examination and for Hpylori testing. The results showed that children age ranged between 2.5-18 years with mean ± SD of 13.6 ± 3.4 and 63.3% were females. The main complaints were epigastric pain in 43.3%, hematemesis in 30% and vomiting in 26.7%. Motility disorders were diagnosed in 66.7% children; in the form of GERD in 63.3% and achalasia in one. Complication of GERD in the form of erosive esophagitis was present in 15.8% children, while Barrett's esophagus was not observed. H. pylori infection was diagnosed in 80% histologically. Eosinophilic esophagitis was not detected. PMID:27363051

  11. Quality of life of patients on chronic parenteral nutrition before and after gastrointestinal tract continuity restoration

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    Ławiński Michał

    2015-04-01

    Full Text Available The issue of the quality of life considering patients with a temporary or permanent intestinal stoma, as well as the necessity for chronic parenteral nutrition at home remain a poorly understood problem. Daily care of the intestinal stoma and the need to comply with sterile procedures required for parenteral nutrition require such patients to commit their time, which secondarily is associated with the broad aspects of social and personal life.

  12. Allergic Mastocytic Gastroenteritis and Colitis: An Unexplained Etiology in Chronic Abdominal Pain and Gastrointestinal Dysmotility

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    A. Akhavein M

    2012-01-01

    Full Text Available Abdominal pain, bloating, early satiety, and changes in bowel habits are common presenting symptoms in individuals with functional GI disorders. Emerging data suggests that these symptoms may be associated with mast cell excess and/or mast cell instability in the GI tract. The aim of this retrospective study was to evaluate the contribution of mast cells to the aforementioned symptoms in individuals with a history of atopic disease. A retrospective chart review of individuals seen in a university GI practice was conducted and twenty-four subjects were identified. The majority had abdominal pain, early satiety, and nocturnal awakening. 66.7% and 37.5% had a history of environmental and/or food allergy. Solid gastric emptying was increased as were the mean number of mast cells reported on biopsies from the stomach, small bowel, and colon (>37/hpf by CD117 staining. Mean whole blood histamine levels were uniformly elevated. This study suggests that in individuals with these characteristics, consideration should be given to staining their gastrointestinal biopsies for mast cells as this may provide them with relatively non-toxic but highly targeted treatment options. Allergic gastroenteritis and colitis may represent a third type of GI mast cell disorder along with mast cell activation syndrome and mastocytic enterocolitis.

  13. Viral genotype and HLA class II alleles influence on extra-hepatic manifestations of chronic HCV infection

    Directory of Open Access Journals (Sweden)

    M. Galeazzi

    2011-09-01

    Full Text Available Objective: To test whether an association between HCV genotype, HLA class II alleles distribution and extra-hepatic manifestations (EHM can be demonstrated in a group of Italian patients with chronic HCV infection . Methods: Sixty patients affected by HCV infection with EHM were consecutively enrolled. 163 HCV patients without EHM were tested as controls for the prevalence of HCV genotypes, while we referred to literature as to the controls for HLA distribution. HCV-RNA was quantified by a RT-PCR. HLA class II alleles typing was performed using a standard microlymphocytotoxicity assay. We used chi-square or Fisher test (p<0.05 significant. Odds Ratio (OR was performed by 2X2 contingency table. Results: HCV 2c genotype was found in 63.46% of patients compared to 19.63% of controls (p<0.0001; OR=7.11. Furthermore, it correlated with carpal tunnel syndrome (p=0.03; OR=4.5 and autoimmune thyroiditis (p=0.02; OR=9.2. On the contrary, 1b genotype protected from EHM in toto (p=0.0004; OR=0.21 and particularly from carpal tunnel syndrome (p=0.0014; OR=0.07. Moreover, 3a genotype prevented HCV people from having cryoglobulinemia (p=0.05; OR=0.11. As to HLA, DR6 seemed to facilitate EHM in HCV patients (p=0.041; OR=1.61, while DQ2 (p=0.03; OR=0.5 and DQ3 (p=0.002; OR= 0.5 may play a protective role. In addition, HLA DR3 was associated with cryoglobulinemia (p=0.02; OR=9.5. Conclusions: According to our findings, 2c genotype can be considered as a major risk factor for developing HCVrelated EHM, while 1b genotype seems to prevent their onset; there are also evidences suggesting that HLA might play a role in chronic HCV infected patients.

  14. Wireless capsule endoscopy in the investigation of patients with chronic renal failure and obscure gastrointestinal bleeding (preliminary data)

    Institute of Scientific and Technical Information of China (English)

    Stephanos Karagiannis; Spyros Goulas; Georgios Kosmadakis; Petros Galanis; Dimitrios Arvanitis; John Boletis; Evangelos Georgiou; Christos Mavrogiannis

    2006-01-01

    AIM: To investigate the role of wireless capsule endoscopy (WCE) in detection of small bowel (SB) pathology in patients with chronic renal failure (CRF) and obscure bleeding.METHODS: Consecutive CRF patients with obscure bleeding were prospectively studied. Patients with normal renal function and obscure bleeding, investigated during the same period with WCE, were used for the interpretation of results.RESULTS: Seventeen CRF patients (11 overt, 6 occult bleeding) and 51 patients (33 overt, 18 occult bleeding) with normal renal function were enrolled in this study.Positive SB findings were detected in 70.6% of CRF patients and in 41.2% of non-CRF patients (P < 0.05). SB angiodysplasia was identified in 47% of CRF patients and in 17.6% of non-CRF patients. Univariate logistic regression revealed CRF as a significant predictive factor for angiodysplasia (P < 0.05). Therapeutic measures were undertaken in 66% of the patients with the positive findings.CONCLUSION: According to our preliminary results, SB angiodysplasia was found in an increased prevalence among CRF patients with obscure bleeding. WCE is useful in diagnosis of gastrointestinal pathologies and in planning appropriate therapeutic intervention and, therefore, should be included in the work-up of this group of patients.

  15. The Genus Aloe: Phytochemistry and Therapeutic Uses Including Treatments for Gastrointestinal Conditions and Chronic Inflammation.

    Science.gov (United States)

    Cock, I E

    2015-01-01

    Plants of the genus Aloe have perhaps the longest recorded history of medicinal usage and are amongst the most widely used plants for traditional medicinal purposes worldwide. Aloe vera, Aloe ferox, Aloe arborescens and Aloe perryi are the best known and most widely used, but many other species are also used for their therapeutic properties. The Aloes have been used since ancient times, particularly for the treatment of microbial infections, gastrointestinal disorders and inflammatory conditions. In addition to their myriad uses in traditional therapeutics, the Aloes have also been used as components of cosmetic formulations, and in the food and beverage industries. Despite their wide acceptance, studies from different laboratories often report wide variations in the therapeutic bioactivities from within the same Aloe species, even when the same extraction procedures are used. Furthermore, leaves from individual Aloe plants within the same species may have widely varying levels of the bioactive phytochemicals. Phytochemical analyses have shown that many Aloe species contain various carbohydrate polymers (notably glucomannans) and a range of other low molecular weight phenolic compounds including alkaloids, anthraquinones, anthrones, benzene and furan derivatives, chromones, coumarins, flavonoids, phytosterols, pyrans and pyrones. There has been a wealth of information published about the phytochemistry and therapeutic potential of the Aloes (especially Aloe vera). Much of this has been contradictory. Intra- and interspecies differences in the redox state of the individual Aloe components and in the ratios of these components may occur between individual plants. These factors may all affect the physiological properties of Aloe extracts. Due to the structure and chemical nature of many of the Aloe phytochemicals, it is likely that many of the reported medicinal properties are due to antioxidant or prooxidant effects. The antioxidant/prooxidant activities of many Aloe

  16. 慢性汞中毒致神经系统损害的临床观察%The neurological manifestations of chronic mercury poisoning

    Institute of Scientific and Technical Information of China (English)

    丁岩; 宋冉; 李存江

    2011-01-01

    目的 分析慢性汞中毒对患者神经系统损害的表现,以提高对慢性汞中毒的临床认识.方法 总结分析2006--2010年首都医科大学宣武医院神经内科收治的8例慢性汞中毒患者的临床资料.结果 慢性汞中毒造成的神经系统损害包括周围神经病变以及感觉异常(6/8例)、思维缓慢及精神异常(3/8例)、肢体无力萎缩(3/8例)、震颤(4/8例)、睡眠障碍(3/8例)等.结论 慢性汞中毒可以有各种各样的神经系统损害的表现,在临床工作中要注意鉴别.尽早诊治会减少患者痛苦.%Objective To analyze the neurological manifestations of chronic mercury poisoning for the improvement of clinical understanding of this disease.Methods The clinical data of 8 cases diagnosed as chronic mercury poisoning admitted in the department of neurology of Xuanwu hospital during the past 5 years were collected and analysed.Results Neurological manifestations of chronic mercury poisoning involved psychological problems,sleep disorders,ataxia,extremities weakness and atrophy,tremor,peripheral neuropathy and paresthesia.Conclusions There are various kinds of neurological manifestations of chronic mercury poisoning.Identification of these manifestations in clinical practice and early diagnosis are beneficial for the relief of pains in the patients.

  17. The association of aggressive and chronic periodontitis with systemic manifestations and dental anomalies in a jordanian population: a case control study

    OpenAIRE

    Karasneh Jumana A; Abbadi Muna S; Taha Anas H; Ababneh Khansa T; Khader Yousef S

    2010-01-01

    Abstract Background The relationship between dental anomalies and periodontitis has not been documented by earlier studies. Although psychological factors have been implicated in the etiopathogenesis of periodontitis, very little information has so far been published about the association of anxiety and depression with aggressive periodontitis. The aim of this study was to investigate the association of chronic periodontitis and aggressive periodontitis with certain systemic manifestations an...

  18. Modern views on the pathogenesis of hard dental tissues and periodontium lesions and means of their treatment in children with chronic diseases of the gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Krupey V.Y.

    2014-09-01

    Full Text Available Changes in the mouth covity often reflect regularities of pathogenesis of a number of disease states, and primarily from the digestive tract. Therefore, the purpose of the study was to clarify pathogenesis of certain lesions of hard dental tissues and periodontal tissues in children with chronic diseases of the gastrointestinal tract and development of schemes for their treatment. The study observed 441 children aged from 7 to 15 years with dental caries and generalized chronic catarrhal gingivitis on the background of chronic gastritis and duodenitis, duodenal ulcer and malabsorption syndrome. All the children were divided into 2 groups - basic and comparison one. The study identified the most dan¬gerous and little-known way of pathogenesis, which passes through the general processes of reducing the production of various proteins (immune system and antiseptics, is a violation of the general and local resistance and, ultimately, mineral metabolism. Such disorders impair complete mineralization of tooth enamel, reduce optimal composition and properties of saliva stimulating glycolysis processes in oral cavity. Prevention of dental caries and generalized chronic catarrhal gingivitis in children with chronic pathology of the gastrointestinal tract is based on the use of developed therapeutic and prophylactic complex, which includes mucosal gel Kvertulin, probiotic Latsidofil and drug Calcium D.

  19. Comparison of Behçet's Disease and Recurrent Aphthous Ulcer According to Characteristics of Gastrointestinal Symptoms

    OpenAIRE

    Rhee, Seung-Ho; Kim, Young-Bae; Lee, Eun-So

    2005-01-01

    Behçet's disease (BD) is a multisystemic chronic inflammatory disease. It is characterized by recurrent oral and genital ulcers, uveitis, skin lesions and other manifestations, including neurologic, vascular, joint, and gastrointestinal ulcers of variable severity. Recurrent aphthous ulcer (RAU) represents a very common, but poorly understood, mucosal disorder. If a patient of RAU without any other typical symptoms of BD has gastrointestinal symptoms, it is difficult to distinguish this RAU f...

  20. “Ninjinto” (Ginseng Decoction, a Traditional Japanese Herbal Medicine, Improves Gastrointestinal Symptoms and Immune Competence in Patients with Chronic Intestinal Failure

    Directory of Open Access Journals (Sweden)

    Shuichiro Uehara

    2015-01-01

    Full Text Available Background. Treating functional gastrointestinal disorders is extremely difficult. We herein report the effect of the oral administration of Ninjinto (NJT, ginseng decoction, a traditional Japanese Kampo medicine, on chronic intestinal failure. Patients and Methods. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. The primary diseases included chronic intestinal pseudoobstruction (CIPO: n=4, short bowel syndrome (SBS: n=2, and intestinal atresia n=1. All patients orally received NJT extract granules at a dose of 0.3 g/kg BW per day. The treatment outcomes were then assessed according to the patients’ symptoms and consecutive abdominal X-ray findings. Results. The targeted symptoms were abdominal distension in four patients, diarrhea in three patients, and frequent hospitalization due to infections in two patients. An improvement in the symptoms was observed in six of the seven patients, whereas one patient with SBS did not show any improvement. An improvement in an abdominal roentgenogram was observed in the four patients with remarkably dilated bowel loops due to CIPO. Conclusions. NJT may be effective in controlling functional gastrointestinal disorders associated with chronic intestinal failure. The use of Kampo medicine in the field of pediatric surgery may help to improve the quality of life in children suffering from such conditions.

  1. Endoscopic evaluation and biopsy collection of the gastrointestinal tract in the green moray eel (Gymnothorax funebris): application in a case of chronic regurgitation with gastric mucus gland hyperplasia.

    Science.gov (United States)

    Meegan, Jenny; Sidor, Inga F; Field, Cara; Roddy, Nicole; Sirpenski, Gayle; Dunn, J Lawrence

    2012-09-01

    A green moray eel (Gymnothorax funebris) was evaluated for chronic regurgitation. By using flexible endoscopy, the gastrointestinal tract was evaluated and revealed multifocal proliferative gastric masses and an intestinal ulcer. Biopsy specimens revealed gastric mucus gland hyperplasia, intestinal nematodiasis, and mild enteritis. Esophagoscopy and gastroscopy were performed by using a larger endoscope (length, 200 cm). A smaller endoscope (length, 100 cm) facilitated entering the intestinal tract in normograde or retrograde directions. A control eel was also evaluated, and no gross or histologic abnormalities were detected. The case eel was treated with metoclopramide and fenbendazole, responded well to therapy, and regurgitation decreased. A year later, the animal died of unrelated causes. Necropsy revealed coelomic gastric adhesions. The gastric proliferative lesions were associated with degeneration and necrosis of gastric pit mucosa without significant inflammation; etiology was unknown. Gastrointestinal endoscopy proved a useful diagnostic tool for evaluation and biopsy collection in this eel species.

  2. 自主神经介导性晕厥儿童消化道症状临床分析%Clinical significance of abdominal pain and other gastrointestinal manifestations in children with autonomic nervous-mediated syncope

    Institute of Scientific and Technical Information of China (English)

    闫辉; 张春雨; 杜军保; 金红芳

    2013-01-01

    目的 认识自主神经介导性晕厥患儿中腹痛等消化道表现的临床意义.方法 2009年1月至2012年3月在北京大学第一医院儿科住院诊断为自主神经介导性晕厥及心因性发作的患儿共108例,对患儿发作前及直立倾斜试验(HUT)中诱发的腹痛、恶心、呕吐等消化道症状进行临床研究.结果 108例患儿中,男49例(45.4%),女59例(54.6%).年龄5~ 17岁(中位年龄11岁).共33例(35.5%)自主神经介导性晕厥患儿在发作前出现胃肠道不适,15例(16.1%)表现为腹痛,20例(21.5%)恶心,12例(12.9%)呕吐.27例(40.9%)在HUT时诱发出胃肠道表现,6例(9.1%)HUT时诱发出腹痛,24例(36.4%)恶心.共39例(59.1%)在发作前或HUT时出现消化道表现.HUT时出现的消化道表现在体位性心动过速综合征(POTS)患儿和血管迷走性晕厥(vvs)患几分别达到40%及41.5%,心因性发作组为0;发作前及HUT时患儿消化道表现在POTS及VVS组分别达到60%及58.5%,明显高于心因性发作(10%)组(P<0.05).自主神经介导性晕厥患儿发作前及HUT时出现消化道症状的危险度是心因性发作患儿的13倍(95%CI均>1).结论 消化道表现是自主神经介导性晕厥的常见症状之一,对于发作前及HUT时发生腹痛、恶心患儿,需注意自主神经介导性晕厥的可能.剧烈腹痛可作为自主神经介导性晕厥的伴随症状.%Objective To investigate the clinical significance of abdominal pain and other gastrointestinal manifestations in autonomic nervous-mediated syncope in children. Methods A total of 108 cases treated in our hospital because of autonomic nervous-mediated syncope or psychogenic pseudosyncope from Jan. 2009 to Mar. 2012 were recruited. The incidences of gastrointestinal symptoms such as abdominal pain, nausea and vomiting before the onset of syncope attack and during upright tilt test processes were analyzed in children with autonomic nervous system-mediated syncope

  3. [Differential diagnostics of chronic tonsillitis based on the severity of manifestations of tonsillogenic intoxication of the organism].

    Science.gov (United States)

    Pal'chun, V T; Gurov, A V; Aksenova, A V; Guseva, O A

    2015-01-01

    The objective of the present study was to elucidate the objective diagnostic criteria for the differentiation between various forms of chronic tonsillitis (CT) based on the results of clinical, bacteriological, and serological investigations. A total of 13 patients presenting with various forms of CT were available for the examination. The mathematical analysis of the data thus obtained made it possible to identify the most clinically significant diagnostic criteria allowing to verify the form of CT. It is concluded that their application in the combination with the classification of chronic tonsillitis proposed earlier by B.S. Preobrazhensky and V.T. Pal'chun can be recommended for the choice of the most adequate strategy for the treatment of the patients chronic tonsillitis on an individual basis. PMID:26525464

  4. Pleural effusion as the initial manifestation of chronic myeloid leukemia: Report of a case with clinical and cytologic correlation

    Directory of Open Access Journals (Sweden)

    Paras Nuwal

    2012-01-01

    Full Text Available Pleural effusion in patients with chronic myeloid leukemia (CML is very rare and poorly understood. We report here a 26-year-old male patient having CML and presenting with pleural effusion as the first clinical sign. The possible mechanism of pleural effusion in CML, the cytological interpretive problem and the clinical significance of finding immature leucocytes in pleural fluid are also briefly discussed.

  5. 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...

  6. Streptococcus bovis septicemia and meningitis associated with chronic radiation enterocolitis

    Energy Technology Data Exchange (ETDEWEB)

    Jadeja, L.; Kantarjian, H.; Bolivar, R.

    1983-12-01

    We describe the first patient with simultaneous S bovis septicemia and meningitis associated with chronic radiation enterocolitis. This case underlines the value of a thorough gastrointestinal evaluation of all patients with S bovis infection, and the need for a neurologic investigation even with minor neurologic manifestations.

  7. Autoimmune Demyelinating Polyneuropathy as a Manifestation of Chronic Graft-versus-Host Disease after Adult Cord Blood Transplantation in a Patient with Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Fredrick Hogan

    2014-01-01

    Full Text Available Immune mediated demyelinating disease after allogeneic stem cell transplantation is a rare entity with unclear etiology. Acute inflammatory demyelinating polyneuropathy (AIDP has been reported after related and adult unrelated allogeneic stem cell transplantation but no such case has been reported after unrelated cord blood transplantation. We hereby present the first case of AIDP after double umbilical cord blood transplantation (DUCBT. A 55-year-old man with chronic lymphocytic leukemia (CLL received a cord blood transplant for relapsed refractory disease with high risk cytogenetics. On day 221, patient presented with skin rash, tingling in both lower extremites, and ascending paralysis that progressed rapidly over the course of 2 days. The workup resulted in a diagnosis of AIDP and administration of intravenous immunoglobulins plus steroids was initiated. Motor and sensory powers were fully recovered and his chronic GVHD was managed for several months with single agent sirolimus.

  8. Chronic inflammatory and non-inflammatory diseases of the gastrointestinal tract in cats: diagnostic advantages of full-thickness intestinal and extraintestinal biopsies.

    Science.gov (United States)

    Kleinschmidt, Sven; Harder, Jasmine; Nolte, Ingo; Marsilio, Sina; Hewicker-Trautwein, Marion

    2010-02-01

    An evaluation of histological findings in full-thickness biopsies from the gastrointestinal tract (GIT) and extraintestinal samples of 43 cats with chronic GIT disease signs was performed. In the majority of cases (46.5%) inflammatory bowel disease, ie, lymphocytic-plasmacytic enteritis/colitis (32.6%), eosinophilic gastroenterocolitis (11.6%) and mixed inflammatory infiltration (2.3%), was diagnosed. Furthermore, in four animals non-inflammatory mucosal band-shaped fibrosis (9.3%), and in 10 cats (23.3%) a diffuse lymphoma, was found. Six cats displayed only a gastritis (7.0%) or lymphangiectasia (7.0%), respectively. In two cats a mast cell tumour (4.7%) was diagnosed. In one cat no histopathological lesions were found. The availability of transmural biopsies from all segments of the intestine and the collection of extraintestinal samples, especially mesenteric lymph nodes, is especially helpful for diagnosing intestinal tumours such as lymphomas and tumours of mast cell origin.

  9. Manifestações sistêmicas na doença pulmonar obstrutiva crônica Systemic manifestations in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Victor Zuniga Dourado

    2006-04-01

    Full Text Available A doença pulmonar obstrutiva crônica é progressiva e está relacionada a uma resposta inflamatória anormal dos pulmões à inalação de partículas e/ou gases tóxicos, sobretudo a fumaça de cigarro. Embora acometa primariamente os pulmões, diversas manifestações extrapulmonares relacionadas a esta enfermidade têm sido descritas. O aumento do número de células inflamatórias, que resulta em produção anormal de citocinas pró-inflamatórias, e o desequilíbrio entre a formação de radicais livres e a capacidade antioxidante, resultando em sobrecarga oxidativa, provavelmente são mecanismos envolvidos na inflamação local e sistêmica. Além disso, a diminuição do condicionamento físico secundária às limitações ventilatórias pode estar envolvida no desenvolvimento de alterações musculares. A doença pulmonar obstrutiva crônica apresenta diversas manifestações sistêmicas que incluem a depleção nutricional, a disfunção dos músculos esqueléticos, que contribui para a intolerância ao exercício, e as manifestações relacionadas a co-morbidades comumente observadas nestes pacientes. Essas manifestações têm sido relacionadas à sobrevida e ao estado geral de saúde dos pacientes. Nesse sentido, esta revisão tem como objetivo discutir os achados da literatura relacionados às manifestações sistêmicas da doença pulmonar obstrutiva crônica, ressaltando o papel da inflação sistêmica, e algumas perspectivas de tratamento.Chronic obstructive pulmonary disease is progressive and is characterized by abnormal inflammation of the lungs in response to inhalation of noxious particles or toxic gases, especially cigarette smoke. Although this infirmity primarily affects the lungs, diverse extrapulmonary manifestations have been described. The likely mechanisms involved in the local and systemic inflammation seen in this disease include an increase in the number of inflammatory cells (resulting in abnormal production

  10. Gastrointestinal and nutritional issues in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Pascolini, Giulia; Blundo, Carlo; Grammatico, Paola

    2015-03-01

    Gastrointestinal involvement is a well known complication of Ehlers-Danlos syndromes (EDSs), mainly in form of abdominal emergencies due to intestinal/abdominal vessels rupture in vascular EDS. In the last decade, a growing number of works investigated the relationship between a wide spectrum of chronic gastrointestinal complaints and various EDS forms, among which the hypermobility type (a.k.a. joint hypermobility syndrome; JHS/EDS-HT) was the most studied. The emerging findings depict a major role for gastrointestinal involvement in the health status and, consequently, management of JHS/EDS-HT patients. Nevertheless, fragmentation of knowledge limits its impact on practice within the boundaries of highly specialized clinics. In this paper, literature review on gastrointestinal manifestations in JHS/EDS-HT was carried out and identified papers categorized as (i) case-control/cohort studies associating (apparently non-syndromic) joint hypermobility and gastrointestinal involvement, (ii) case-control/cohort studies associating JHS/EDS-HT and gastrointestinal involvement, (iii) case reports/series on various gastrointestinal complications in (presumed) JHS/EDS-HT, and (iv) studies reporting gastrointestinal features in heterogeneous EDS patients' cohorts. Gastrointestinal manifestations of JHS/EDS-HT were organized and discussed in two categories, including structural anomalies (i.e., abdominal/diaphragmatic hernias, internal organ/pelvic prolapses, intestinal intussusceptions) and functional features (i.e., dysphagia, gastro-esophageal reflux, dyspepsia, recurrent abdominal pain, constipation/diarrhea), with emphasis on practice and future implications. In the second part of this paper, a summary of possible nutritional interventions in JHS/EDS-HT was presented. Supplementation strategies were borrowed from data available for general population with minor modifications in the light of recent discoveries in the pathogenesis of selected JHS/EDS-HT features. PMID

  11. [Disturbances of gastrointestinal motility of the stomach in patients with chronic gastric erosions and biliary tract disease].

    Science.gov (United States)

    Svintsitskyĭ, A S; Solovĭova, H A

    2012-12-01

    Article dwells on comparison data about motor function of the stomach in the three groups of patients: with gastric erosions and biliary tract diseases, duodenal ulcer disease, chronic gastritis. It is shown, that patients with gastric erosions and biliary tract diseases are characterized by slower evacuation function of the stomach, hypotonus of the stomach. Frequency of duodenal reflux in this group of patients is very high (85,9 %).

  12. Imaging of Drug-induced Complications in the Gastrointestinal System.

    Science.gov (United States)

    McGettigan, Melissa J; Menias, Christine O; Gao, Zhenqiang J; Mellnick, Vincent M; Hara, Amy K

    2016-01-01

    Drug-induced injury commonly affects the gastrointestinal and hepatobiliary systems because of the mechanisms of absorption and metabolism. In pill esophagitis, injury is frequently related to direct contact with the esophageal mucosa, resulting in small superficial ulcers in the mid esophagus. Nonsteroidal anti-inflammatory drugs can lead to gastrointestinal tract ulcers and small bowel mucosal diaphragms (thin weblike strictures). Injury to the pancreatic and hepatobiliary systems can manifest as pancreatitis, acute or chronic hepatitis, cholestasis, or steatosis and steatohepatitis (which may progress to cirrhosis). Various drugs may also insult the hepatic vasculature, resulting in Budd-Chiari and sinusoidal obstructive syndromes. Focal lesions such as hepatic adenomas may develop after use of oral contraceptives or anabolic steroids. Ultrasonography, computed tomography, and magnetic resonance imaging can aid in diagnosis of drug-induced injuries and often are necessary to exclude other causes. PMID:26761532

  13. 慢性空洞性肺曲菌病临床表现%Clinical manifestation of chronic cavitary pulmonary aspergillosis

    Institute of Scientific and Technical Information of China (English)

    刘爱华; 陆京伯; 苏瑾; 吴雷

    2010-01-01

    Objective To discuss the clinical manifestation,imaging characteristic,diagnosis and treatment of chronic cavitary pulmonary aspergillosis(CCPA).Methods Clinical data of three patients with CCPA were summarized,who had ever been misdiagnosed as pulmonary tuberculosis for a long time and failed to treatment with antituberculosis drugs,even aggravated to have lung injury,and were pathologically confirmed as CCPA by surgery or transbronchial lung biopsy.Results Chronic cough,fatigue,or short breath were common clinical symptoms of CCPA.Imaging results showed that cavitary lesions appeared in the upper lobe of lung,which increased progressively,and sometimes were multiple.Histological examination showed that fungal hyphae cound be found in the cavity,chronic inflammation and pulmonary fibrosis appeared in surrounding lung tissue,accompanying pleural thickening.Conclusions CCPA is a subtype of chronic pulmonary aspergillosis,which is rare in clinic.The imaging characteristic is mainly that cavitary lesions increase progressively.Fungal hyphae can be found in the cavity by histological examination.For CCPA patients,antifungal therapy should be taken actively,and surgery can be taken if necessary.%目的 探讨慢性空洞性肺曲菌病的临床症状、影像学特点、诊断和治疗方法.方法 对3例误诊为肺结核而长期抗结核治疗无效,甚至导致肺毁损,经手术切除病变肺叶或经支气管肺活检术,病理确诊为慢性空洞性肺曲菌病的临床资料进行总结.结果 慢性空洞性肺曲菌病常见的临床症状为慢性咳嗽、疲劳不适,严重者出现气短.影像学显示空洞出现在肺上叶,且进行性增大,有时为多发.组织学检查在空洞内可找到真菌菌丝,周围肺组织有慢性炎症和肺纤维化,伴有胸膜肥厚.结论 慢性空洞性肺曲菌病是慢性肺曲菌病的一种亚型,临床上少见,常见影像学特点是肺内空洞进行性增大,组织学检查在空洞内可找到真菌

  14. Carcinoembryonic antigen: assay following heat compared with perchloric acid extraction in patients with colon cancer, non-neoplastic gastrointestinal diseases, or chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Witherspoon, L.R.; Shuler, S.E.; Alyea, K.; Husserl, F.E.

    1983-10-01

    Heat inactivation has been proposed as an alternative to perchloric acid (PCA) precipitation for the extraction of carcinoembryonic antigen (CEA) from human plasma. A commercial RIA kit using heat inactivation was examined and results compared with those obtained with PCA precipitation. Adequate sensitivity (1.5 ..mu..g CEA/I plasma), satisfactory analytical recovery of CEA added to plasma, and dilutional linearity of samples found to have elevated CEA concentrations, were demonstrated for the heat-inactivation assay. Between-assay precision was better with the heat inactivation than with the PCA assay. Although the absolute concentration of CEA estimated after heat inactivation was consistently lower than that estimated after PCA extraction of plasma specimens, there was excellent correlation between results obtained with the two methods in colon cancer patients free of disease, colon cancer patients with residual or recurrent disease, patients with benign gastrointestinal disease, and in patients with chronic renal failure. The heat-inactivation assay is an excellent alternative to the PCA assay.

  15. Carcinoembryonic antigen: assay following heat compared with perchloric acid extraction in patients with colon cancer, non-neoplastic gastrointestinal diseases, or chronic renal failure.

    Science.gov (United States)

    Witherspoon, L R; Shuler, S E; Alyea, K; Husserl, F E

    1983-10-01

    Heat inactivation has been proposed as an alternative to perchloric acid (PCA) precipitation for the extraction of carcinoembryonic antigen (CEA) from human plasma. We examined a commercial RIA kit using heat inactivation, and compared results with those obtained with PCA precipitation. Adequate sensitivity (1.5 micrograms CEA/l plasma), satisfactory analytical recovery of CEA added to plasma, and dilutional linearity of samples found to have elevated CEA concentrations, were demonstrated for the heat-inactivation assay. Between-assay precision was better with the heat inactivation than with the PCA assay. Although the absolute concentration of CEA estimated after heat inactivation was consistently lower than that estimated after PCA extraction of plasma specimens, there was excellent correlation between results obtained with the two methods in colon cancer patients free of disease, colon cancer patients with residual or recurrent disease, patients with benign gastrointestinal disease, and in patients with chronic renal failure. We conclude that the heat-inactivation assay is an excellent alternative to the PCA assay.

  16. Dieulafoy Lesion in the Ascending Colon Presenting with Gastrointestinal Bleeding and Severe Anemia Complicated by a Coexisting Severe Resistant Chronic Idiopathic Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    Sherif Ali Eltawansy

    2014-01-01

    Full Text Available Background. GI (gastrointestinal bleeding can be due to a variety of etiologies ranging from being common like bleeding peptic ulcer disease or esophageal varices. One of the rarely documented causes is the Dieulafoy lesion which is known as an abnormally large ectatic artery that penetrates the gut wall, occasionally eroding through the mucosa causing massive bleeding. In addition to that, we refer to the uncommon presentation of Dieulafoy lesion itself as it is well known to be found in the stomach, esophagus, duodenum, and jejunum but not the ascending colon as in our case. The patient had a coexisting ITP (idiopathic thrombocytopenic purpura that was resistant to different therapies. Case Report. We report a case of a 48-year-old Egyptian female known for chronic ITP resistant to treatment. The patient presented with bright red bleeding per rectum and severe life threatening anemia. Endoscopic study showed a Dieulafoy lesion. Endoscopic clipping was successful in controlling the bleeding. Conclusion. Dieulafoy lesion is a rare reason for GI bleeding and can present in common or unexpected places. Also extreme caution should be used in patients with bleeding tendency due to different reasons, like ITP in our case.

  17. High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease

    Science.gov (United States)

    Čeović, Romana; Desnica, Lana; Pulanić, Dražen; Serventi Seiwerth, Ranka; Ilić, Ivana; Grce, Magdalena; Mravak Stipetić, Marinka; Klepac Pulanić, Tajana; Bilić, Ervina; Bilić, Ernest; Milošević, Milan; Vrhovac, Radovan; Nemet, Damir; Pavletic, Steven Z

    2016-01-01

    Aim To determine the frequency and the characteristics of cutaneous manifestations, especially vitiligo and alopecia areata, in patients with chronic graft-vs-host disease (cGVHD). Methods 50 patients with cGVHD were prospectively enrolled in the observational study protocol and evaluated by an experienced dermatologist. The evaluation was focused on the clinical spectrum of skin and adnexal involvement, and the cutaneous GVHD score was determined according to National Institutes of Health (NIH) Consensus criteria. The presence of vitiligo, alopecia, xerosis, nail changes, and dyspigmentation was also assessed. Results Out of 50 cGVHD patients, 28 (56%) had skin involvement, and 27 of them (96%) had hypo and/or hyperpigmentations. 11 patients (39%) had a mild cutaneous NIH cGVHD score, 22% moderate, and 39% severe. 15 (30%) patients had nail changes and 10 (20%) had vitiligo or alopecia areata. Univariate analysis showed that patients with vitiligo/alopecia areata received more lines of prior systemic immunosuppressive therapy (P = 0.043), had lower Karnofsky performance status (P = 0.028), and had a higher B-cell number (P = 0.005), platelet count (P = 0.022), and total protein (P = 0.024). Vitiligo and alopecia areata were associated with higher NIH skin score (P = 0.001), higher intensity of immunosuppressive treatment (P = 0.020), and total body irradiation conditioning (P = 0.040). Multivariate regression model showed that patients with higher NIH skin scoring were 3.67 times more likely to have alopecia and/or vitiligo (odds ratio 3.67; 95% confidence interval 1.26-10.73), controlled for all other factors in the model (age at study entry, number of B-cells, platelet count, and global NIH score). Conclusion These data indicate that vitiligo and alopecia areata occur more frequently in cGVHD than previously reported. PMID:27374824

  18. An experimental model for simultaneous chronic sampling of portal and systemic blood and gastrointestinal lymph via cannulae in conscious swine.

    Science.gov (United States)

    Manolas, K J; Farmer, H M; Cussen, M; Welbourn, R B

    1983-10-01

    Surgical techniques are described whereby safe chronic cannulations of the portal vein, the external iliac artery and vein and the cisterna chyli of pigs were performed. The pigs tolerated the operations well and there was a short recovery period. They were unrestrained during the subsequent feeding experiments, when large sequential blood and lymph samples were withdrawn readily. The experimental periods varied from 3 to 46 days (mean : 13.4 days, SE: 2.0). All of 22 arterial cannulae remained patent (mean : 16 days, SE : 2.2), nineteen of 22 portal cannulae (mean : 15 days, SE : 1.8) and eighteen of 22 venous cannulae (mean : 14 days, SE : 1.9). The lymph cannula patency varied from 2 to 7 days, but lymph samples were easily obtained through all but one of them during the third postoperative day. PMID:6627950

  19. Extraintestinal manifestations of inflammatory bowel disease: Do they influence treatment and outcome?

    Institute of Scientific and Technical Information of China (English)

    Fernando Tavarela Veloso

    2011-01-01

    Crohn's disease and ulcerative colitis are chronic inflammatory bowel diseases that often involve organs other than those of the gastrointestinal tract. Immune-related extraintestinal manifestations (EIMs) are usually related to disease activity, but sometimes may take an independent course. Globally, about one third of patients develop these systemic manifestations. Phenotypic classification shows that certain subsets of patients are more susceptible to developing EIMs, which frequently occur simultaneously in the same patient overlapping joints, skin, mouth, and eyes. The clinical spectrum of these manifestations varies from mild transitory to very severe lesions, sometimes more incapacitating than the intestinal disease itself. The great majority of these EIMs accompany the activity of intestinal disease and patients run a higher risk of a severe clinical course. For most of the inflammatory EIMs, the primary therapeutic target remains the bowel. Early aggressive therapy can minimize severe complications and maintenance treatment has the potential to prevent some devastating consequences.

  20. Comparison of Behcet's disease and recurrent aphthous ulcer according to characteristics of gastrointestinal symptoms.

    Science.gov (United States)

    Rhee, Seung-Ho; Kim, Young-Bae; Lee, Eun-So

    2005-12-01

    Behcet's disease (BD) is a multisystemic chronic inflammatory disease. It is characterized by recurrent oral and genital ulcers, uveitis, skin lesions and other manifestations, including neurologic, vascular, joint, and gastrointestinal ulcers of variable severity. Recurrent aphthous ulcer (RAU) represents a very common, but poorly understood, mucosal disorder. If a patient of RAU without any other typical symptoms of BD has gastrointestinal symptoms, it is difficult to distinguish this RAU from true BD with gastrointestinal involvement. Because pathognomonic clinical features and tools are absent, the differential diagnosis of these two diseases relies on the characteristic clinical features and the judgement of an experienced physician. Sixty-five out of a total 960 RAU patients and forty-four of 556 BD patients with gastrointestinal symptoms between January 1996 and December 2003 participated in this study. All were evaluated with esophagogastroduodenoscopy and colonoscopy. Clinical, endoscopic and histopathologic findings were analyzed and ELISA tests were conducted to detect serum levels of ASCA and pANCA. No significant difference was found between the two groups. Differential diagnosis between RAU with gastrointestinal symptoms and BD with gastrointestinal involvement requires further prospective, large-scale study. PMID:16361807

  1. [Gastrointestinal bleeding].

    Science.gov (United States)

    Lanas, Ángel

    2015-09-01

    In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage. The need for urgent endoscopy before 6-12 h after the onset of upper gastrointestinal bleeding episode may be beneficial in patients with hemodynamic instability and high risk for comorbidity. It is confirmed that in Western but not in Japanese populations, gastrointestinal bleeding episodes admitted to hospital during weekend days are associated with a worse prognosis associated with delays in the clinical management of the events. The strategy of a restrictive policy on blood transfusions during an upper GI bleeding event has been challenged. Several studies have shown the benefit of identifying the bleeding vessel in non varicose underlying gastric lesions by Doppler ultrasound which allows direct endoscopic therapy in the patient with upper GI bleeding. Finally, it has been reported that lower gastrointestinal bleeding diverticula band ligation or hemoclipping are both safe and have the same long-term outcomes. PMID:26520197

  2. Gastrointestinal lesions associated with spondyloarthropathies

    Institute of Scientific and Technical Information of China (English)

    Ambrogio Orlando; Sara Renna; Giovanni Perricone; Mario Cottone

    2009-01-01

    Subclinical gut inflammation has been described in up to two-thirds of patients with spondyloarthropathies (SpA). Arthritis represents an extra-intestinal manifestation of several gastrointestinal diseases,including inflammatory bowel disease (IBD), Whipple's disease, Behcet's disease, celiac disease, intestinal bypass surgery, parasitic infections of the gut and pseudomembranous colitis. Moreover about twothirds of nonsteroidal anti-inflammatory drug users demonstrate intestinal inflammation. Arthritis may manifest as a peripheral or axial arthritis. The spondyloarthropathy family consists of the following entities:ankylosing spondylitis, undifferentiated spondyloar thr i t is, react ive ar thr i t is, psor iat i c arthritis, spondyloarthritis associated with IBD,juvenile onset spondyloarthritis. This topic reviews the major gastrointestinal manifestations that can occur in patients with SpA and in nonsteroidal antiinflammatory drugs users.

  3. Extrahepatic manifestations of chronic hepatitis C and their influence on response to treatment with Pegylated interferon alfa-2a and ribavirin

    Directory of Open Access Journals (Sweden)

    Fabri Milotka

    2013-01-01

    Full Text Available Introduction. Thirty to 50% of patients with chronic hepatitis C (CHC have one or more extrahepatic manifestations (EHMs of hepatitis C virus (HCV infection. Objective. The aim of this study was to evaluate the frequency of EHMs and to investigate the efficacy of pegylated interferon (Peg­IFN­α­2a plus ribavirin therapy in patients with HCV­related EHMs. Methods. The study included 280 patients suffering from CHC and treated with Peg­IFN­α­2a and ribavirin. The patients were divided in two groups according to presence or absence of EHMs. We evaluated virological response to antiviral therapy. Results. One or more EHMs were found among 27.9% of patients. Most frequently they had rheumatoid factor in serum (12.5%, organ­nonspecific antibodies ANA and AGMA (12.4%, thyroid hormone disorders (9.3%, vasculitis (5.7%, diabetes mellitus (4.65%, glomerulonephritis (0.71%, and porphyria cutanea tarda (0.36%. Among the patients with EHMs there was 52.6% of females vs. 30.2% of females in the group of patients without EHMs (p=0.001. HCV genotypes 1 and 4 had 85.9% patients with EHMs vs. 58.4% of patients without EHMs (p=0.000. Progressive fibrosis and cirrhosis were more frequently recorded in the EHM group of patients (32% vs. 23.2%, but without statistically significant difference (p=0.532. Serious adverse events of Peg­IFN­α­2a and ribavirin were statistically significantly recorded among the patients with EHMs (46.1% vs. 12.9%; p=0.000. Sustained virological response among the patients with and without EHMs rated 56.9% and 70.8% respectively (p=0.125. Conclusion. Patients with CHC and EHMs treated with combined Peg­IFN­α­2a and ribavirin experience handling difficulties, more often have serious adverse events, while successful outcome is achieved in about 50% of patients.

  4. Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

    Institute of Scientific and Technical Information of China (English)

    Jin-Gook Huh; Myoung-Don Oh; You-Sun Kim; Jong-Sung Lee; Tae-Yeob Jeong; Soo-Hyung Ryu; Jung-Hwan Lee; Jeong-Seop Moon; Yun-Kyung Kang; Myung-Shup Shim

    2008-01-01

    Chronic diarrhea is one of the most frequent gastro-intestinal manifestations in acquired immunodeficiency syndrome (AIDS).Protozoa and nontuberculous mycobacteria (NTM) are opportunistic pathogens that can easily infect these patients.Among the NTM,Mycobacterium avium complex (MAC) is the most frequently observed pathogen in HIV-infected patients.However,NTMs other than MAC have not been reported as a gastrointestinal pathogen as yet.We present a case of chronic diarrhea in an AIDS patient in whom Mycobacterium ulcerans and cryptosporidium co-infection is evidenced from colonic tissue.

  5. 儿童慢性肉芽肿病胸部CT表现%Chest CT manifestations of chronic granulomatous disease in children

    Institute of Scientific and Technical Information of China (English)

    赵晶; 彭芸; 贺建新

    2012-01-01

    Objective To describe the thoracic CT features of chronic granulomatous disease in children. Methods The chest CT and Laboratory test were retrospectively analyzed and summarized in 30 diagnosed CGD between June 2004 and December 2009. Results Most patients presented with respiratory infections. 23 patients were younger than 2 years old. CT discovered mediastinal and/or hilar lymphadcnopathy in 27 patients, lymph nodes calcification in 17 patients, including 14 patients with ipsilateral axillary lymph node calcification after BCG vaccine. CT findings also included areas of consolidation in 19 paticnts, nodules and masses in 24 cases. Cavities in consolidation and nodules were found in 12 patients, in-terlobular septal thickening in 11 cases, pleural thickening in 10 patients, small amount of pleural effusion in 10 patients, bronchiectasis in 9 patients. These children had a total of 33 tests. 5 times were aspergillus infections in 21 clear tests of pathogen review. This result was coincided with CT findings . Imaging tips for aspergillus infections accounted for 4 times in 12 unclear pathogen review. Conclusion Thoracic CT manifestations of chronic granulomatous disease in children include consolidation, nodules, masses and cavities, with interstitial changes in common. Nodules and masses are highly suggestive of aspergillus infection, especially when pathogen tests are not clear, and imagings on the tips of aspergillus infections will be of great help. Mediastinal and/or hilar lymphadenopathy. ipsilateral axillary lymph node calcification after BCG vaccine has certain particularity, which is very useful for clinician to make diagnosis.%目的 分析儿童慢性肉芽肿病(CGD)胸部CT的特征性表现.方法 搜集我院2004年6月~2009年12月确诊的30例CGD患儿,对其胸部CT及实验室检查进行回顾性分析和总结.结果 30例CGD患儿,发病年龄小于2岁的有23例,大多数患儿以呼吸道感染来诊,CT发

  6. Cardiopulmonary Manifestations of Ankylosing Spondylitis

    OpenAIRE

    Mahnaz Momeni; Nora Taylor; Mahsa Tehrani

    2011-01-01

    Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS). AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, intersti...

  7. Thinking and Strategy on the Diagnosis and Treatment of Functional Gastrointestinal Disorders with Integrative Medicine

    Institute of Scientific and Technical Information of China (English)

    张声生

    2009-01-01

    The functional gastrointestinal disorders (FGIDs) are a group of diseases mainly manifested as gastrointestinal functional disorders,including 45 kinds of different diseases,such as functional dyspepsia(FD), irritable bowel syndrome (IBS),functional constipation

  8. Probiotics and Chronic Gastrointestinal Disease

    Science.gov (United States)

    Guarner, Francisco

    Human beings are associated in a symbiotic relationship with a huge population of microorganisms. During millennia, a considerable number of microbes have evolved and adapted to live and grow in the human intestine. The intestinal habitat of an individual contains billions of microorganisms including bacteria, protozoa, archaea, fungi, and viruses (Guarner and Malagelada, 2003; Ley et al., 2006), and the number of microbial cells within the gut lumen appears to be ten times larger than the number of eukaryotic cells of the human body. Some of these bacteria are potential pathogens and can be a source of infection and sepsis under some circumstances, for instance when the integrity of the bowel barrier is physically or functionally breached. However, growing evidence suggests that important health benefits to the human host derive from the constant interaction with its microbial guests. Recognition of these benefits in recent years is drawing particular attention to the functional implications of the gut microbial communities in host physiology.

  9. Abdominal manifestations of cystic fibrosis in adults: a review

    International Nuclear Information System (INIS)

    Gastrointestinal manifestations of disease are present in most adults with cystic fibrosis. Radiologists are familiar with the classical imaging characteristics of end-stage pulmonary disease and the radiological findings of meconium ileus in neonates. As most patients now live into adulthood, recognition of the imaging appearances of abdominal disease is important to enable prompt diagnosis and treatment. Accordingly, this article presents typical imaging appearances of the adult gastrointestinal manifestations of cystic fibrosis. Copyright (2004) Blackwell Science Pty Ltd

  10. Unusual clinical manifestations of leptospirosis

    Directory of Open Access Journals (Sweden)

    Bal A

    2005-01-01

    Full Text Available Leptospirosis has protean clinical manifestations. The classical presentation of the disease is an acute biphasic febrile illness with or without jaundice. Unusual clinical manifestations may result from involvement of pulmonary, cardiovascular, neural, gastrointestinal, ocular and other systems. Immunological phenomena secondary to antigenic mimicry may also be an important component of many clinical features and may be responsible for reactive arthritis. Leptospirosis in early pregnancy may lead to fetal loss. There are a few reports of leptospirosis in HIV- infected individuals but no generalisation can be made due to paucity of data. It is important to bear in mind that leptospiral illness may be a significant component in cases of dual infections or in simultaneous infections with more than two pathogens.

  11. Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease

    Science.gov (United States)

    ... list of Celiac Disease Organizations​​ . Alternate Language URL Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease (For Health ... this page: Symptoms Causes Diagnosis Treatment Clinical Trials Dermatitis herpetiformis (DH) is a chronic, intensely itchy, blistering ...

  12. Chronic inflammatory demyelinating polyradiculoneuropathy in a patient with Crohn's disease.

    Science.gov (United States)

    Ohyagi, Masaki; Ohkubo, Takuya; Yagi, Yousuke; Ishibashi, Satoru; Akiyama, Junko; Nagahori, Masakazu; Watanabe, Mamoru; Yokota, Takanori; Mizusawa, Hidehiro

    2013-01-01

    Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract that is frequently accompanied by systemic complications. Neuropathologies have not been well investigated as extraintestinal manifestations of CD. We herein report the case of a 36-year-old man with CD who presented with progressive weakness and numbness. A neurological examination and the results of a nerve conduction study and a sural nerve biopsy led to a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Plasma exchanges were initially effective; however, the effects gradually declined starting 10 days after the plasma exchange (PE). These results suggest that humoral factors may play an important role in CIDP associated with CD.

  13. Imaging manifestations of chronic obstructive pulmonary disease complicated with pulmonary tuberculosis%慢性阻塞性肺疾病合并肺结核的影像表现

    Institute of Scientific and Technical Information of China (English)

    冯光; 李宁; 王文秀; 王力; 郑浩; 高江峰

    2014-01-01

    Objective To explore the imaging manifestations of chronic obstructive pulmonary disease com-plicated with pulmonary tuberculosis. Methods 143 cases of chronic obstructive pulmonary disease complicated with pulmonary tuberculosis were divided into the group A, and another 120 cases of chronic obstructive pulmonary disease complicated with pulmonary infection were taken as the group B. The lesions′location and range and the nature of le-sions were analyzed. Results There was no significant difference in lesions nodules, patchy fibrosis, and flaky exu-dative lesions (P>0. 05). But there were obvious differences in upper lobe segment and dorsal segment of lower lobe basal segment involvement, leaves, lesions of calcification, diaphragmatic surface adhesion, multi form lesions mixed, with effusion change (P0.05;累及上叶尖后段和下叶背段,累及下叶基底段,病变性质的钙化灶、膈面粘连、多形态病灶混合、伴积液改变,差异具有统计学意义(P<0.05)。结论 COPD合并肺结核影像表现为病变范围广泛,呈多肺叶散开模式,不典型部位经常被累及,多性状病灶混合存在,病变影像改变缓慢。

  14. Dermatological Manifestations of Postural Tachycardia Syndrome Are Common and Diverse

    Science.gov (United States)

    Deb, Anindita; Culbertson, Collin; Morgenshtern, Karen; DePold Hohler, Anna

    2016-01-01

    Background and Purpose Postural tachycardia syndrome (POTS) is a syndrome of orthostatic intolerance in the setting of excessive tachycardia with orthostatic challenge, and these symptoms are relieved when recumbent. Apart from symptoms of orthostatic intolerance, there are many other comorbid conditions such as chronic headache, fibromyalgia, gastrointestinal disorders, and sleep disturbances. Dermatological manifestations of POTS are also common and range widely from livedo reticularis to Raynaud's phenomenon. Methods Questionnaires were distributed to 26 patients with POTS who presented to the neurology clinic. They were asked to report on various characteristics of dermatological symptoms, with their answers recorded on a Likert rating scale. Symptoms were considered positive if patients answered with "strongly agree" or "agree", and negative if they answered with "neutral", "strongly disagree", or "disagree". Results The most commonly reported symptom was rash (77%). Raynaud's phenomenon was reported by over half of the patients, and about a quarter of patients reported livedo reticularis. The rash was most commonly found on the arms, legs, and trunk. Some patients reported that the rash could spread, and was likely to be pruritic or painful. Very few reported worsening of symptoms on standing. Conclusions The results suggest that dermatological manifestations in POTS vary but are highly prevalent, and are therefore of important diagnostic and therapeutic significance for physicians and patients alike to gain a better understanding thereof. Further research exploring the underlying pathophysiology, incidence, and treatment strategies is necessary. PMID:26610893

  15. Simultaneous Manifestation of Chronic Myelomonocytic Leukemia and Multiple Myeloma during Treatment by Prednisolone and Eltrombopag for Immune-Mediated Thrombocytopenic Purpura.

    Science.gov (United States)

    Hagihara, Masao; Inoue, Morihiro; Kodama, Kenichiro; Uchida, Tomoyuki; Hua, Jian

    2016-01-01

    An 80-year-old man was admitted to our hospital because of severe thrombocytopenia. He was diagnosed with idiopathic thrombocytopenia, and prednisolone together with eltrombopag was started, leading to significant improvement of platelet counts. Four years later, there was a prominent increase of peripheral blood monocytes, which was accompanied by recurrence of thrombocytopenia. Bone marrow aspirates and serum electrophoresis revealed coexistence of chronic myelomonocytic leukemia (CMML) and multiple myeloma (MM). The patient received lenalidomide plus dexamethasone therapy but died due to exacerbation of the disorder. It was supposed that thrombocytopenia was secondarily caused by CMML and MM developed at a later period. PMID:27597907

  16. A preliminary study of the prevalence of intestinal parasites in immunocompromised patients with and without gastrointestinal manifestations Frequência de parasitas intestinais em pacientes imunocomprometidos com e sem manifestações gastrointestinais: estudo preliminar

    Directory of Open Access Journals (Sweden)

    Jorge Humberto Botero

    2003-08-01

    Full Text Available The objective of the present study was to determine the prevalence of the intestinal parasites most commonly found in immunocompromised patients. A group of 111 individuals with acute lymphoid leukaemia (ALL, chronic myeloid leukaemia (CML, human immunodeficiency virus (HIV and other immunocompromised conditions (principally haematological disorders was selected. A battery of tests was performed on each individual to identify the presence of parasites (three stool specimens with saline solution and Lugol both directly and by concentration, culture and special staining. No significant differences were found among the frequencies of the different parasites with the several types of immunocompromised conditions. The overall frequencies of potentially pathogenic and opportunistic parasites were 32.4% (36/111 and 9% (10/111 respectively, the most frequently encountered among the latter being Cryptosporidium sp., Microsporidia spp. and Strongyloides stercoralis.O objetivo do presente estudo é avaliar a frequência de parasitas intestinais em pacientes com alterações imunológicas. Foram analisadas 111 pessoas com leucemia linfóide aguda (LLA, leucemia mieloide crônica, virus da imunodeficiência humana (VIH e outras doenças, principalmente alterações sanguíneas. Para cada indivíduo foram realizados exames seriados de fezes tanto com solução salina quanto com lugol #3, direto e por concentração, culturas de fezes e colorações específicas. Não houve diferenças significativas na frequência de parasitoses nos distintos grupos avaliados. A frequência de parasitas potencialmente patogênicos foi de 32.4% (36/111 enquanto a de parasitas oportunistas foi de 9.0% (10/111. As espécies mais observadas foram C. parvum, microsporídios spp. e S. stercoralis.

  17. Imaging of gastrointestinal and abdominal tuberculosis

    NARCIS (Netherlands)

    Vanhoenacker, FM; De Backer, AI; Op de Beeck, B; Maes, M; Van Altena, R; Van Beckevoort, D; Kersemans, P; De Schepper, AM

    2004-01-01

    This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic cha

  18. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

    Institute of Scientific and Technical Information of China (English)

    Bong; Sik; Matthew; Kim; Bob; T; Li; Alexander; Engel; Jaswinder; S; Samra; Stephen; Clarke; Ian; D; Norton; Angela; E; Li

    2014-01-01

    Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is notapparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.

  19. Manifestations of perihepatic lymph nodes in acute flare of chronic hepatitis B: association with HBeAg status and with HBeAg seroconversion.

    Directory of Open Access Journals (Sweden)

    Yen-Ling Ko

    Full Text Available It has been observed that enlargement of perihepatic lymph nodes may be seen in patients with chronic hepatitis B, particularly during acute flares of CHB. We hypothesized that there may be a correlation between the nodal change patterns in CHB patients with acute flare and HBeAg status. Perihepatic lymph node sizes of 87 patients with acute flares of CHB were documented, with a median follow up of 43 months. Patients were separated into 3 groups, HBeAg-positive with HBe seroconversion (group 1, HBeAg-positive without HBe seroconversion (group 2, and HBeAg-negative (group 3. Group 1 has the highest incidence of enlarged lymph nodes (92.3% compared with group 2 (75.8% and group 3 (46.8% (p = 0.003. And if nodal width at acute flare was > 8mm and interval change of nodal width was >3mm, the incidence of HBeAg seroconversion will be 75% (p<0.001.Larger perihepatic lymph nodes are seen in CHB acute flare patients with positive HBeAg and the magnitude of nodal width change may predict HBeAg seroconversion at recovery.

  20. Isolated Ocular Manifestation of Relapsed Chronic Myelogenous Leukemia Presenting as Myeloid Blast Crisis in a Patient on Imatinib Therapy: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Rohit Gulati

    2015-01-01

    Full Text Available Blast phase in chronic myelogenous leukemia (CML has rarely been reported to involve extramedullary sites like skin, lymph nodes, and central nervous system. Clinical history, characteristic hematologic findings (elevated leukocyte counts, myelocytic predominance, and basophilia, and Philadelphia chromosome are of high diagnostic significance especially in isolated extramedullary presentations. We describe a unique case of CML relapse with blast phase involving the eye. A 66-year-old man with a known diagnosis of CML on imatinib and in molecular remission for 3 years presented with a painful blind eye. Histologic examination revealed diffuse involvement of choroid, iris, vitreous humor, and the optic nerve by blast cells. The blasts expressed CD34, aberrant TdT, and a myeloid phenotype (CD13, CD33, and CD117. Fluorescence in situ hybridization (FISH of vitreous fluid detected BCR-ABL1 gene rearrangement. Additionally, trisomy 8 and gains of 9 and 22 were seen which were not present in the initial diagnostic marrow study 3 years ago. At relapse, the bone marrow, peripheral blood, and the cerebrospinal fluid were not involved by CML. Patient received induction chemotherapy and single dose prophylactic intrathecal methotrexate and was maintained on antityrosine kinase therapy and eventually underwent allogenic stem cell transplantation.

  1. Molecular pathogenesis of plasminogen Hakodate: the second Japanese family case of severe type I plasminogen deficiency manifested late-onset multi-organic chronic pseudomembranous mucositis.

    Science.gov (United States)

    Osaki, Tsukasa; Souri, Masayoshi; Song, Young-Seok; Izumi, Naohiro; Law, Ruby; Ichinose, Akitada

    2016-08-01

    A 64-year-old man first developed ligneous conjunctivitis at the age of 58 years after right pulmonary resection because of suspected cancer; otherwise, he had been healthy. Since then, he began to suffer from various forms of chronic pseudomembranous mucositis. Laboratory tests demonstrated that he had 7.8 % of plasminogen activity and 5.9 % of the normal antigen level. Thus, he was diagnosed as having severe type I plasminogen deficiency, making him the third case in Japan. DNA sequencing and PCR-restriction fragment length polymorphism analyses revealed that this patient was a compound heterozygote of a G-to-A missense mutation (G266E) in exon VIII and a g-to-a mutation at the obligatory splicing acceptor site in intron 12 (IVS12-1g>a). These two mutations were confirmed to be novel. Molecular modeling and splice site strength calculation predicted conformational disorder(s) for the Glu266 mutant and a drastic decrease in splicing efficiency for intron 12, respectively. Western blot analysis demonstrated that the patient contained a small amount of the normal-sized plasminogen protein. Mass spectrometric analysis of the patient's plasminogen revealed a peptide containing the wild-type Gly266 residue and no peptides with mutations at Glu266. However, he had never suffered from thrombosis. Low levels of fibrinogen/fibrin degradation products (FDP), D-dimer, and plasmin-α2-plasmin inhibitor complex clearly indicated a hypo-fibrinolytic condition. However, his plasma concentration of elastase-digested crosslinked FDPs was 4.8 U/mL, suggesting the presence of an on-going plasmin(ogen)-independent "alternative" fibrinolytic system, which may protect the patient from thrombosis. The patient has been free from recurrence of ligneous conjunctivitis for approximately 2.5 years. PMID:27193180

  2. Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients.

    Science.gov (United States)

    Castori, Marco; Camerota, Filippo; Celletti, Claudia; Danese, Chiara; Santilli, Valter; Saraceni, Vincenzo Maria; Grammatico, Paola

    2010-03-01

    Hypermobility type Ehlers-Danlos syndrome (HT-EDS) is a relatively frequent, although commonly misdiagnosed variant of Ehlers-Danlos syndrome, mainly characterized by marked joint instability and mild cutaneous involvement. Chronic pain, asthenia, and gastrointestinal and pelvic dysfunction are characteristic additional manifestations. We report on 21 HT-EDS patients selected from a group of 40 subjects with suspected mild hereditary connective tissue disorder. General, mucocutaneous, musculoskeletal, cardiovascular, neurologic, gastrointestinal, urogynecological, and ear-nose-throat abnormalities are investigated systematically and tabulated. Six distinct clinical presentations of HT-EDS are outlined, whose tabulation is a mnemonic for the practicing clinical geneticist in an attempt to diagnose this condition accurately. With detailed clinical records and phenotype comparison among patients of different ages, the natural history of the disorder is defined. Three phases (namely, hypermobility, pain, and stiffness) are delineated based on distinguishing manifestations. A constellation of additional, apparently uncommon abnormalities is also identified, including dolichocolon, dysphonia, and Arnold-Chiari type I malformation. Their further investigation may contribute to an understanding of the pathogenesis of the protean manifestations of HT-EDS, and a more effective approach to the evaluation and management of affected individuals. PMID:20140961

  3. Cardiovascular manifestations of phaeochromocytoma

    NARCIS (Netherlands)

    Prejbisz, A.; Lenders, J.W.M.; Eisenhofer, G.; Januszewicz, A.

    2011-01-01

    Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma,

  4. Gastrointestinal bleeding and iron absorption in the experimental blind loop syndrome.

    Science.gov (United States)

    Giannella, R A; Toskes, P P

    1976-07-01

    Rats with surgically created self-filling jejunal blind loops and the blind loop syndrome manifested gastrointestinal bleeding and hyperabsorption of iron. Although the mean hematocrit and serum iron levels of rats with self-filling blind loops became overtly anemic and manifested low-serum iron levels. It is suggested that the documented gastrointestinal bleeding in these rats with the experimental blind loop syndrome is another manifestation of damage to the intestinal epithelium in conditions of small intestinal bacterial overgrowth.

  5. Diagnostic Value of Clinical Manifestation for Etiology of Chronic Cough in Children%临床资料对儿童慢性咳嗽病因的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张晓波; 农光民

    2011-01-01

    Objective To explore the value of clinical manifestation for etiological diagnosis in children with chronic cough.Methods A prospective cohort study of 117 patients with chronic cough who referred to the First Affiliated Hospital of Guangxi Medical University from Dec.2008 to Jan.2010.The etiological diagnostic procedure adopted in this study was suggested for children by pediatric branch of chinese medical association.The detailed clinical manifestation and etiology of chronic cough were acquired in recruited children.Results The causes of chronic cough in children were cough variant asthma (CVA), upper airway cough syndrome (UACS), postinfectious cough (PIC), allergic cough ( AC ), Tourette's syndrome ( TS), psychogenic cough ( PC ).Dry cough occurred in the morning or evening and increasing cough after exercise suggested CVA ,while UACS had wet cough and nasal symptoms.PIC often had 2 months' duration.PC could have loud dry cough during daytime and TS often with tics.Genders, passive smoking, personal and family history of allergy had no help for etiological diagnosis of chronic cough.Sinusitis, allergic rhinitis and adenoidal hypertrophy were the common reasons of UACS.CVA always had high eosinophil count or positive skin prick test.Conclusions CVA, UACS, PIC were the common reasons for chronic cough in children.Clinical manifestation was useful to identify the etiology of chronic cough in children.Age, course, nature of cough were helpful for etiological diagnosis.Upper airway abnormality ,especially sinusitis may suggest UACS.High eosinophic count or positive skin prick test can support the diagnosis of CVA.%目的 探讨临床资料对儿童慢性咳嗽病因的诊断价值.方法 选择2008年12月-2010年1月在广西医科大学第一附属医院儿科就诊的慢性咳嗽患儿117例,通过前瞻性的临床研究方法 ,获得慢性咳嗽患儿详细的临床资料和病因,分析临床资料对病因诊断的作用.结果 本组慢性咳嗽的病因

  6. Cardiopulmonary Manifestations of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Mahnaz Momeni

    2011-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS. AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, interstitial lung disease, ventilatory impairment due to chest wall restriction, sleep apnea, and spontaneous pneumothorax. They are many reports detailing pathophysiology, hypothesized mechanisms leading to these derangements, and estimated prevalence of such findings in the AS populations. At this time, there are no clear guidelines regarding a stepwise approach to screen these patients for cardiovascular and pulmonary complications.

  7. [Lyme disease--clinical manifestations and treatment].

    Science.gov (United States)

    Stock, Ingo

    2016-05-01

    Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings.

  8. [Lyme disease--clinical manifestations and treatment].

    Science.gov (United States)

    Stock, Ingo

    2016-05-01

    Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings. PMID:27348896

  9. Gastrointestinal events with clopidogrel

    DEFF Research Database (Denmark)

    Grove, Erik Lerkevang; Würtz, Morten; Schwarz, Peter;

    2013-01-01

    Clopidogrel prevents cardiovascular events, but has been linked with adverse gastrointestinal (GI) complications, particularly bleeding events.......Clopidogrel prevents cardiovascular events, but has been linked with adverse gastrointestinal (GI) complications, particularly bleeding events....

  10. Disorders of gastrointestinal hypomotility.

    Science.gov (United States)

    Bielefeldt, Klaus; Tuteja, Ashok; Nusrat, Salman

    2016-01-01

    Ingestion and digestion of food as well as expulsion of residual material from our gastrointestinal tract requires normal propulsive, i.e. motor, function. Hypomotility refers to inherited or acquired changes that come with decreased contractile forces or slower transit. It not only often causes symptoms but also may compromise nutritional status or lead to other complications. While severe forms, such as pseudo-obstruction or ileus, may have a tremendous functional impact, the less severe forms of hypomotility may well be more relevant, as they contribute to common disorders, such as functional dyspepsia, gastroparesis, chronic constipation, and irritable bowel syndrome (IBS). Clinical testing can identify changes in contractile activity, defined by lower amplitudes or abnormal patterns, and the related effects on transit. However, such biomarkers show a limited correlation with overall symptom severity as experienced by patients. Similarly, targeting hypomotility with pharmacological interventions often alters gut motor function but does not consistently improve symptoms. Novel diagnostic approaches may change this apparent paradox and enable us to obtain more comprehensive information by integrating data on electrical activity, mechanical forces, patterns, wall stiffness, and motions with information of the flow of luminal contents. New drugs with more selective effects or more specific delivery may improve benefits and limit adverse effects. Lastly, the complex regulation of gastrointestinal motility involves the brain-gut axis as a reciprocal pathway for afferent and efferent signaling. Considering the role of visceral input in emotion and the effects of emotion on visceral activity, understanding and managing hypomotility disorders requires an integrative approach based on the mind-body continuum or biopsychosocial model of diseases. PMID:27583135

  11. Zinc and gastrointestinal disease

    Institute of Scientific and Technical Information of China (English)

    Sonja; Skrovanek; Katherine; DiGuilio; Robert; Bailey; William; Huntington; Ryan; Urbas; Barani; Mayilvaganan; Giancarlo; Mercogliano; James; M; Mullin

    2014-01-01

    This review is a current summary of the role that both zinc deficiency and zinc supplementation can play in the etiology and therapy of a wide range of gastrointestinal diseases. The recent literature describing zinc action on gastrointestinal epithelial tight junctions and epithelial barrier function is described. Zinc enhancement of gastrointestinal epithelial barrier function may figure prominently in its potential therapeutic action in several gastrointestinal diseases.

  12. Liver manifestations of cystic fibrosis

    International Nuclear Information System (INIS)

    Chronic liver disease is one of the major complications of cystic fibrosis (CF). Significant liver disease is seen in 13-25% of children with CF. Improved life expectancy and prolonged follow-up have favored better characterization of the hepatic manifestations of CF and allowed direct observation of an increasing number of liver-related events. Liver disease typically develops in the first decade of life, with the incidence dropping rapidly after the age of 10 years. The wide spectrum of liver disease ranging from asymptomatic gallbladder abnormalities to biliary cirrhosis will be reviewed in this article

  13. Acquired haemophilia complicated with gastrointestinal bleeding and spontaneous iliopsoas muscle haematoma in a woman with chronic C hepatitis under treatment with pegylated IFN alpha 2a and ribavirin.

    Science.gov (United States)

    Boţianu, Ana-Maria; Demian, Smaranda; Macarie, Ioan; Georgescu, Dan; Oltean, Galafteon; Băţagă, Simona

    2012-03-01

    Acquired haemophilia A is a very rare (1-2 cases per million people) but often life-threatening haemorrhagic disorder characterized by antibodies directed against coagulation factor VIII. We report the case of a 55-year old woman under treatment with Pegylated alpha 2a interferon (IFN) and Ribavirin for chronic viral C hepatitis, who developed a progressive severe haemorrhagic syndrome diagnosed as acquired haemophilia based on supplementary laboratory data (prolonged activated partial thromboplastin time, extremely low factor VIII level - 1%, high titre of factor VIII inhibitor - 30 Bethesda U/ml).The onset was insidious, about three months before presenting to our unit. Antiviral therapy had been stopped three weeks before current admission. Emergency intensive treatment included: haemostatic agents - rFVII (Novoseven), FEIBA (Factor VIII Inhibitor Bypassing Activity), vitamin K, adrenostazin, cryoprecipitate, fresh frozen plasma, as well as immunosuppressive therapy (high dose corticotherapy and cyclophoshamide), immunoglobulins (Humaglobin), prophylactic PPI and antibiotics. The evolution was slowly favourable with the remission of the haemorrhagic syndrome and regression of the iliopsoas muscle haematoma. Clinicians should be aware that acquired forms of haemophilia do exist, representing a rare diagnosis and a therapeutic challenge. To our knowledge, this is the first reported case of acquired haemophilia in Romania, in a patient with chronic viral C hepatitis under antiviral treatment. PMID:22457865

  14. Acquired haemophilia complicated with gastrointestinal bleeding and spontaneous iliopsoas muscle haematoma in a woman with chronic C hepatitis under treatment with pegylated IFN alpha 2a and ribavirin.

    Science.gov (United States)

    Boţianu, Ana-Maria; Demian, Smaranda; Macarie, Ioan; Georgescu, Dan; Oltean, Galafteon; Băţagă, Simona

    2012-03-01

    Acquired haemophilia A is a very rare (1-2 cases per million people) but often life-threatening haemorrhagic disorder characterized by antibodies directed against coagulation factor VIII. We report the case of a 55-year old woman under treatment with Pegylated alpha 2a interferon (IFN) and Ribavirin for chronic viral C hepatitis, who developed a progressive severe haemorrhagic syndrome diagnosed as acquired haemophilia based on supplementary laboratory data (prolonged activated partial thromboplastin time, extremely low factor VIII level - 1%, high titre of factor VIII inhibitor - 30 Bethesda U/ml).The onset was insidious, about three months before presenting to our unit. Antiviral therapy had been stopped three weeks before current admission. Emergency intensive treatment included: haemostatic agents - rFVII (Novoseven), FEIBA (Factor VIII Inhibitor Bypassing Activity), vitamin K, adrenostazin, cryoprecipitate, fresh frozen plasma, as well as immunosuppressive therapy (high dose corticotherapy and cyclophoshamide), immunoglobulins (Humaglobin), prophylactic PPI and antibiotics. The evolution was slowly favourable with the remission of the haemorrhagic syndrome and regression of the iliopsoas muscle haematoma. Clinicians should be aware that acquired forms of haemophilia do exist, representing a rare diagnosis and a therapeutic challenge. To our knowledge, this is the first reported case of acquired haemophilia in Romania, in a patient with chronic viral C hepatitis under antiviral treatment.

  15. Role of Endoscopic Ultrasound in Gastrointestinal Surgery

    OpenAIRE

    Biswanath P Gouda; Gupta, Tarun

    2011-01-01

    Endoscopic Ultrasound is an emerging diagnostic tool in the field of Gastrointestinal Surgery. Our review article focuses on role of EUS in staging cancers (esophageal, gastric, biliary and rectal), detection of bilio-pancreatic calculi and diagnosis of chronic pancreatitis. Potential for performing EUS based therapeutic interventions are been explored and looks promising from the initial reports.

  16. Semen Allergy Manifesting As Chronic Pruritus Vulva

    Directory of Open Access Journals (Sweden)

    Pavithran K

    1997-01-01

    Full Text Available A young woman of 24 with personal and family history of atopy development pruritus vulva each time after sexual intercourse with her husband. History of urticaria of sites of contact with semen on her thighs gave suspicion of contact urticaria. Positive wheal and flare response to pin prick test with semen, excellent therapeutic response to topical steroid and oral Cetirizine and non- recurrence of the problem after using condom by her husband confirmed the diagnosis of semen allergy.

  17. Abdominal manifestations of cystic fibrosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Chaudry, Gulraiz; Navarro, Oscar M.; Levine, Daniel S.; Oudjhane, Kamaldine [University of Toronto, Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)

    2006-03-15

    Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)

  18. Abdominal manifestations of cystic fibrosis in children

    International Nuclear Information System (INIS)

    Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)

  19. [Neuropsychiatric manifestations ushering pernicious anemia].

    Science.gov (United States)

    Mrabet, S; Ellouze, F; Ellini, S; Mrad, M F

    2015-12-01

    vary according to studies and age range. Digestive and hematological manifestations are well known. Neurological and psychiatric manifestations of pernicious anemia were also described in the early literature. They can be the initial symptoms or the only ones. However, inaugural neuropsychiatric features are often unrecognized. The most common psychiatric symptoms were depression, mania, psychotic symptoms, cognitive impairment and obsessive compulsive disorder. Neurological involvement includes mainly combined spinal sclerosis, peripheral neuropathy and dementia. Cerebellar ataxia and movement disorders are reported less often. Severity of neuropsychiatric features and therapeutic efficacy depends on the duration of signs and level of B12 deficiency. Macrocytic anemia may lack. Neuropsychiatric manifestations could be isolated or be the first manifestation of vitamin deficiency and occur without any hematological or gastrointestinal context. Pernicious anemia and serum B12 assay should be discussed in all patients with organic mental disorders, atypical psychiatric symptoms and fluctuation of symptomatology. Nevertheless, B12 level could be normal in genuine pernicious anemia diseases and macrocytic anemia may lack. Substitutive vitaminotherapy is required when diagnosis is strongly suspected and etiologic assessment is negative. PMID:26345354

  20. PARANEOPLASTIC MANIFESTATIONS IN CHILDREN

    NARCIS (Netherlands)

    DEGRAAF, JH; TAMMINGA, RYJ; KAMPS, WA

    1994-01-01

    Paraneoplastic manifestations are signs and symptoms observed in patients with cancer, distant from the tumour or its metastases and not caused by invasion, obstruction or bulk mass. In children with cancer, paraneoplastic manifestations are rare and distinct from those observed in adults. Knowledge

  1. Rheumatic manifestations of scurvy.

    Science.gov (United States)

    Ferrari, Claudia; Possemato, Niccolò; Pipitone, Nicolò; Manger, Bernhard; Salvarani, Carlo

    2015-04-01

    This paper reviews the rheumatological manifestations of scurvy, based on articles published in English from 1965 until October 2014, with a particular focus on rheumatological manifestations. Scurvy is a rare, uncommon disease in developed countries. Due to its clinical heterogeneity, the disease can easily mimic rheumatologic conditions leading to a delay in diagnosis and treatment. PMID:25854491

  2. Chronic liver disease related mortality pattern in northern Pakistan

    International Nuclear Information System (INIS)

    Objective: To describe the mortality pattern pertaining to chronic liver disease (CLD) in Northern Pakistan. Results: There were a total of 8529 admissions in twelve months period from August 2001 to July 2002. There were 283 (3.31%) total deaths. Out of these, 160 deaths were pertaining to medical causes. Out of these medical cases, 33 (20.6%) patients had died of chronic liver disease. Other major causes of death were cerebro-vascular accident (18.7%), malignancy (18.1%) and acute myocardial infarction (10.6%). Out of 33 patients of CLD, 12 (36%) presented with acute gastrointestinal (Gl) bleeding, 9(27%) presented with Ascites and 6(18%) presented with altered mental status due to hepatic encephalopathy. Rest of them had jaundice and fever as their initial presentation. Out of these 33 patients with CLD, 23 (70%) had hepatitis C virus (HCV) as cause of their liver disease, 4 (12%) had hepatitis B virus (HBV) infection, 3(9%) had both hepatitis B and hepatitis C virus infections and 3 (9%) had no known cause of their chronic liver disease. Conclusion: Chronic liver disease is a major cause of mortality in this part of Pakistan at a tertiary care hospital. HCV infection is the main cause of chronic liver disease followed by either HBV or a combination of these viruses. Major manifestations of CLD have been gastrointestinal bleeding, hepatic failure and portal hypertension.(author)

  3. Effectiveness and gastrointestinal tolerability during conversion and titration with once-daily OROS® hydromorphone extended release in opioid-tolerant patients with chronic low back pain

    Directory of Open Access Journals (Sweden)

    Hale ME

    2013-05-01

    Full Text Available Martin E Hale,1 Srinivas R Nalamachu,2 Arif Khan,3 Michael Kutch4,* 1Gold Coast Research, LLC, Weston, FL, USA; 2International Clinical Research Institute, Overland Park, KS, USA; 3MedNorthwest Clinical Research Center, Bellevue, WA, USA; Duke University Medical Center, Durham, NC, USA; 4Applied Clinical Intelligence, LLC, Bala Cynwyd, PA, USA *Affiliation at the time this work was completed. Michael Kutch is currently affiliated with Cytel Inc, Chesterbrook, PA, USA Purpose: To describe the efficacy and safety of hydromorphone extended-release tablets (OROS hydromorphone ER during dose conversion and titration. Patients and methods: A total of 459 opioid-tolerant adults with chronic moderate to severe low back pain participated in an open-label, 2- to 4-week conversion/titration phase of a double-blind, placebo-controlled, randomized withdrawal trial, conducted at 70 centers in the United States. Patients were converted to once-daily OROS hydromorphone ER at 75% of the equianalgesic dose of their prior total daily opioid dose (5:1 conversion ratio, and titrated as frequently as every 3 days to a maximum dose of 64 mg/day. The primary outcome measure was change in pain intensity numeric rating scale; additional assessments included the Patient Global Assessment and the Roland–Morris Disability Questionnaire scores. Safety assessments were performed at each visit and consisted of recording and monitoring all adverse events (AEs and serious AEs. Results: Mean (standard deviation final daily dose of OROS hydromorphone ER was 37.5 (17.8 mg. Mean (standard error of the mean [SEM] numeric rating scale scores decreased from 6.6 (0.1 at screening to 4.3 (0.1 at the final titration visit (mean [SEM] change, -2.3 [0.1], representing a 34.8% reduction. Mean (SEM change in Patient Global Assessment was -0.6 (0.1, and mean change (SEM in the Roland–Morris Disability Questionnaire was -2.8 (0.3. Patients achieving a stable dose showed greater improvement

  4. 捏脊疗法在治疗消化道慢性炎症疾病的临床应用%Clinical application of chiropractic therapy in the treatment of gastrointestinal chronic inflammatory diseases

    Institute of Scientific and Technical Information of China (English)

    林小兰; 唐勇; 李珍

    2012-01-01

    目的 研究捏脊疗法在治疗消化道慢性炎症性疾病的应用,并探讨其相关原理.方法 将120例慢性消化道炎症性疾病患者随机分为对照组和治疗组,每组各60例.对照组采用常规治疗方法;治疗组除采取常规治疗方法外另外再采用捏脊疗法治疗.比较两组患者的便血、消化不良、便秘、腹痛、腹泻等症状的改善情况.结果 对照组中,共有25例便血,22例消化不良,16例腹泻,13例腹痛,8例便秘.经治疗后症状消失46例,改善17例,无变化或加重21例.而治疗组中,共有28例便血,21例消化不良,17例腹痛,14例腹泻,6例便秘.经治疗后症状消失72例、改善11例、无变化或加重3例.治疗组的总体症状改善率(96.51%)高于对照组(75.00%),差异有统计学意义(P<0.05).结论 对于消化道慢性炎症性疾病,在常规疗法基础上加用捏脊疗法可以明显提高治疗效果,减少相关症状发生.%Objective To study the clinical application of chiropractic therapy in the treatment of gastrointestinal chronic inflammatory diseases, and to explore its associated principles. Methods 120 cases of patients with chronic gastrointestinal inflammatory disease were randomly divided into control group and treatment group, each group had 60 cases. The control group received conventional treatment methods. Addition to the conventional treatment methods, the treatment group received chiropractic treatment. Compare between the two groups to improve the situation of the patient's blood in the stool, indigestion, constipation, abdominal pain, diarrhea symptoms. Results In the control group, a total of 25 cases of blood in the stool, and 22 cases of indigestion, diarrhea in 16 cases, 13 cases of abdominal pain, 8 cases of constipation, symptoms disappeared of 46 cases, to improve the 17 cases, no change or increase the 21 cases after treatment. In the experimental group, a total of 28 cases of blood in the stool, 21 cases of

  5. Gastrointestinal mucosal barrier function and diseases.

    Science.gov (United States)

    Oshima, Tadayuki; Miwa, Hiroto

    2016-08-01

    The gastrointestinal mucosal barrier plays an essential role in the separation of the inside of the body from the outside environment. Tight junctions (TJs) are the most important component for construction of a constitutive barrier of epithelial cells, and they regulate the permeability of the barrier by tightly sealing the cell-cell junctions. TJ proteins are represented by claudins, occludin, junctional adhesion molecules, and scaffold protein zonula occludens. Among these TJ proteins, claudins are the major components of TJs and are responsible for the barrier and the polarity of the epithelial cells. Gastrointestinal diseases including reflux esophagitis, inflammatory bowel disease, functional gastrointestinal disorders, and cancers may be regulated by these molecules, and disruption of their functions leads to chronic inflammatory conditions and chronic or progressive disease. Therefore, regulation of the barrier function of epithelial cells by regulating the expression and localization of TJ proteins is a potential new target for the treatment of these diseases. Treatment strategies for these diseases might thus be largely altered if symptom generation and/or immune dysfunction could be regulated through improvement of mucosal barrier function. Since TJ proteins may also modify tumor infiltration and metastasis, other important goals include finding a good TJ biomarker of cancer progression and patient prognosis, and developing TJ protein-targeted therapies that can modify patient prognosis. This review summarizes current understanding of gastrointestinal barrier function, TJ protein expression, and the mechanisms underlying epithelial barrier dysregulation in gastrointestinal diseases. PMID:27048502

  6. [Neurological and psychiatric aspects of some gastrointestinal diseases].

    Science.gov (United States)

    Aszalós, Zsuzsa

    2008-11-01

    The gastrointestinal tract is controlled by the independent enteric nervous system. It is also closely connected to the central nervous system, and bi-directional communication exists between them. The communication involves neural pathways as well as immune and endocrine mechanisms. The brain-gut axis plays a prominent role in the modulation of gut functions. Signals from different sources (e.g. sound, sight, smell, somatic and visceral sensations, pain) reach the brain. These inputs are modified by memory, cognition and affective mechanisms and integrated within the neural circuits of the central nervous system, spinal cord, autonomic and enteral nervous systems. These inputs can have physiologic effects, such as changes in motility, secretion, immune function, and blood flow to the gastrointestinal tract. One of the most important neurotransmitters is serotonin that plays a key role in the pathogenesis of the most common chronic functional gastrointestinal disorder: the irritable bowel syndrome. It is a biopsychosocial disease, resulting from the dysregulation of the brain-gut axis. Endogenous pain facilitation rather than inhibition, pathologic gradation of visceral perception and reduced threshold for pain are all evident in these patients. Abuse history is common in their anamnesis. Exaggerated conscientiousness, perfectionism, oversensitivity, feeling of deficiency in effectiveness, and higher demand for social parity, neuroticism and alexithymia have been detected among their constant personality features. Females are also characterized by gender role conflict and low assertiveness. Antidepressants and psychotherapy have important roles in their treatment. Also patients with inflammatory bowel disease are characterized by neuroticism and alexithymia and altered mother-child attachment is often described in their anamnesis. Autonomic neuropathy is a frequent and early neurological complication. Reflux disease and obstructive sleep apnea mutually generate

  7. Gastrointestinal hormones regulating appetite

    OpenAIRE

    Chaudhri, Owais; Small, Caroline; Bloom, Steve

    2006-01-01

    The role of gastrointestinal hormones in the regulation of appetite is reviewed. The gastrointestinal tract is the largest endocrine organ in the body. Gut hormones function to optimize the process of digestion and absorption of nutrients by the gut. In this capacity, their local effects on gastrointestinal motility and secretion have been well characterized. By altering the rate at which nutrients are delivered to compartments of the alimentary canal, the control of food intake arguably cons...

  8. Effects of radiation upon gastrointestinal motility

    Institute of Scientific and Technical Information of China (English)

    Mary F Otterson

    2007-01-01

    Whether due to therapeutic or belligerent exposure, the gastrointestinal effects of irradiation produce symptoms dreaded by a majority of the population. Nausea, vomiting, diarrhea and abdominal cramping are hallmarks of the prodromal phase of radiation sickness, occurring hours to days following radiation exposure. The prodromal phase is distinct from acute radiation sickness in that the absorptive, secretory and anatomic changes associated with radiation damage are not easily identifiable. It is during this phase of radiation sickness that gastrointestinal motility significantly changes. In addition, there is evidence that motor activity of the gut contributes to some of the acute and chronic effects of radiation.

  9. Clinical manifestations and arsenic methylation after a rare subacute arsenic poisoning accident.

    Science.gov (United States)

    Xu, Yuanyuan; Wang, Yi; Zheng, Quanmei; Li, Bing; Li, Xin; Jin, Yaping; Lv, Xiuqiang; Qu, Guang; Sun, Guifan

    2008-06-01

    One hundred and four workers ingested excessive levels of arsenic in an accident caused by leakage of pipeline in a copper-smelting factory. Clinical examinations were performed by physicians in a local hospital. Excreted urinary arsenic species were determined by cold trap hydride generation atomic absorption spectrometry. In the initial toxic phase, gastrointestinal symptoms were predominant (83 people, 79.8%). Most patients showed leucopenia (72 people, 69.2%), and increased serum alanine aminotransferase (84 people, 80.8%) and aspartate aminotransferase (58 people, 55.8%). Thirty-five patients (33.6%) had elevated red blood cells in urine. After 17 days of admission, many subjects (45 people, 43.3%) developed peripheral neuropathy and 25 of these 45 patients (24.0%) showed a decrease in motor and sensory nerve conduction velocity. In the comparison of urinary arsenic metabolites among subacute arsenic-poisoned, chronic high arsenic-exposed and control subjects, we found that subacute arsenic-poisoned patients had significantly elevated proportions of urinary inorganic arsenic (iAs) and methylarsonic acid (MMA) but reduced proportion of urinary dimethylarsinic acid (DMA) compared with chronic high arsenic-exposed and control subjects. Chronic exposed subjects excreted higher proportions of iAs and MMA but lower proportions of DMA in urine compared with control subjects. These results suggest that gastrointestinal symptoms, leucopenia, and hepatic and urinary injury are predominant in the initial phase of subacute arsenic poisoning. Peripheral neuropathy is the most frequent manifestation after the initial phase. The biomethylation of arsenic decreases in a dose rate-dependent manner.

  10. Insidious manifestation of pyogenic liver abscess caused by Streptococcus intermedius and Micrococcus luteus: a case report.

    Science.gov (United States)

    Ioannou, Antreas; Xenophontos, Eleni; Karatsi, Alexandra; Petrides, Christos; Kleridou, Maro; Zintilis, Chrysostomos

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora.

  11. Intraperitoneal ectopic infestation of parasites invading through gastrointestinal tract : CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Kon; Rha, Sung Eun; Ha, Hyun Kwon; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho [Asan Medical Center, Ulsan Univ., Ulsan (Korea, Republic of); Choi, Byung Ihn [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Shim, Jae Chul [Inje Univ. College of Medicine, Kimhae (Korea, Republic of); Kim, Hyun [St. Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Lee, Jong Hwa; Ham, Soo Youn [Ulsan Univ. Hospital, Ulsan (Korea, Republic of)

    1999-03-01

    The purpose of this study was to evaluate the CT findings of parasitic ectopic infestation in the peritoneal cavity, a transitional route for parasites invading the gastrointestinal tract, to migrate to various target organs. CT scans of nine patients with pathologically(n=8) or serologically(n=1) proven intraperitoneal involvement of parasitic infestation were retrospectively reviewed. The primary causes of parasitic infestation in nine patients were Paragonimus westermani(n=5), Sparganosis(n=2), and hepatic fascioliasis(n=2). We analyzed the CT findings with regard to the sites and patterns of lesions in the peritoneal cavity and gastrointestinal track, as well as in other solid organs. The clinical features of these patients were also evaluated. The clinical symptoms and signs were chronic abdominal pain and general weakness in seven patients, while peripheral blood eosinophilia was observed in four. The CT features of these nine patients included multiseptated cystic masses of 2-6cm, diameter (mean 4.1{+-}1.7cm) in the omentum or mesentery in six(67%), omental or mesenteric infiltration in seven(78%), focal peritoneal thickening in seven(78%), 1ymphadenopathy in five(56%), and ascites in four(44%). In six of the nine patients, the gastrointestinal tract(stomach in four, colon in one, both stomach and colon in one) was concomitantly involved with focal wall thickening. Branching patterns of hypoattenuating lesions were noted in the liver of three patients; two of these had hepatic fascioliasis and one had paragonimiasis. Ectopic parasitic infestation in the peritoneal cavity manifests as mass formation, adjacent gastrointestinal wall thickening, and focal peritonitis. An understanding of these image features is important for both early diagnosis and adequate treatment.

  12. Primary gastrointestinal lymphoma

    Institute of Scientific and Technical Information of China (English)

    Prasanna Ghimire; Guang-Yao Wu; Ling Zhu

    2011-01-01

    Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type. Although lymphoma can involve any part of the gastrointestinal tract, the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions. Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract, although recently the frequency of other forms has also increased in certain regions of the world. Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma, they are not specific,thus mandating histopathological analysis for its definitive diagnosis. There has been a tremendous leap in the diagnosis, staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways.

  13. [Pulmonary manifestations in rheumatoid arthritis].

    Science.gov (United States)

    Morawska, Justyna; Domysławska, Izabela; Bagrowska, Magdalena; Sierakowski, Stanislaw

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by destructive cartilages, bones and other structures formed joints. RA belongs to connective tissue diseases represented by systemic nature, internal illness, extra-articular features and rapidly progress of atherosceirosis. The extra-articular complications cause the reduction of patient longevity. The frequency of symptoms in patient with RA and respiratory disorders occur in 10-20% of cases. Pulmonary complications are the second most common cause of premature of patient deaths. Respiratory disorders associated with RA are devided into 3 groups: infection, lung disease caused by drugs and pulmonary manifestation connected by RA. These last affect interstitial tissue, bronchioli, pulmonary vessels, pleura, also are presented by pulmonary rheumatoid nodules and pulmonary hypertension.

  14. Dengue fever: atypical manifestation

    Directory of Open Access Journals (Sweden)

    Nataraj Gangasiddaiah

    2014-08-01

    Full Text Available Dengue fever is affecting millions of population globally. For the past one decade, we have seen several outbreaks and even causing significant mortality of affected population. We witnessed numerous pattern and multisystem presentation of dengue in this period. The CNS manifestation like encephalitis, polyneuropathy (GB like syndrome and paresthesias were uncommonly reported priorly. Pancreatitis, polyserositis, carditis of varying severity and hepatic failure are the, some of atypical manifestations observed in recent out breaks. So dengue illness can presents with multi system involvement and can account to significant mortality. Here an attempt was done to present varying, uncommon and atypical manifestation of dengue illness. [Int J Res Med Sci 2014; 2(4.000: 1804-1806

  15. [Unusual Migraine Manifestations].

    Science.gov (United States)

    Schipper, Sivan; Gantenbein, Andreas R; Sandor, Peter S

    2016-06-01

    Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensoric and motoric system) may be affected on different levels. Around a fourth of the patients have migraine aura. The most common aura is the visual aura, followed by sensoric aura. But motoric deficits as well as deficits of higher cortical centers (disorders of thinking, orientation, coherence or concentration) may occur as well. In analogy with a headache calendar, an aura calendar can deliver important help in the diagnostic process of rare migraine manifestations and prevent underdiagnosis of unusual migraine manifestations. Complex migraine manifestations are diagnoses of exlusion, and a broad diagnostic work-up is warranted in order to exclude dangerous neurologic pathologies. There are no specific therapeutic recommendations, as there is a lack of randomized controlled studies.

  16. [Unusual Migraine Manifestations].

    Science.gov (United States)

    Schipper, Sivan; Gantenbein, Andreas R; Sandor, Peter S

    2016-06-01

    Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensoric and motoric system) may be affected on different levels. Around a fourth of the patients have migraine aura. The most common aura is the visual aura, followed by sensoric aura. But motoric deficits as well as deficits of higher cortical centers (disorders of thinking, orientation, coherence or concentration) may occur as well. In analogy with a headache calendar, an aura calendar can deliver important help in the diagnostic process of rare migraine manifestations and prevent underdiagnosis of unusual migraine manifestations. Complex migraine manifestations are diagnoses of exlusion, and a broad diagnostic work-up is warranted in order to exclude dangerous neurologic pathologies. There are no specific therapeutic recommendations, as there is a lack of randomized controlled studies. PMID:27269777

  17. Pulmonary manifestations of leptospirosis

    Directory of Open Access Journals (Sweden)

    Sameer Gulati

    2012-01-01

    Full Text Available Leptospirosis has a spectrum of presentation which ranges from mild disease to a severe form comprising of jaundice and renal failure. Involvement of the lung can vary from subtle clinical features to deadly pulmonary hemorrhage and acute respiratory distress syndrome. Of late, it has been identified that leptospirosis can present atypically with predominant pulmonary manifestations. This can delay diagnosis making and hence optimum treatment. The purpose of this review is to bring together all the reported pulmonary manifestations of leptospirosis and the recent trends in the management.

  18. Cardiovascular manifestations in hyperthyroidism

    OpenAIRE

    Vairamani Kandan; Sathyamurthy P; Rajkumar M; Lavanya Narayanan

    2016-01-01

    Background: It is well known that thyroid hormone directly affects the heart and peripheral vascular system. In hyperthyroidism, cardiovascular manifestations are frequent findings. Atrial arrhythmias, limitations in exercise tolerance, and congestive heart failure were reported to occur more common in older patients as a result of hyperthyroidism. Cardiovascular signs of hyperthyroidism include tachycardia, widened pulse pressure, marked increase in cardiac output with impaired cardiovascula...

  19. Clinical Effect of Xinqingning (新清宁) Combined with Low Dose Continuous Gastrointestinal Dialysis in Treating Uremia

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the clinical effect of Xinqingning (XQN), a preparation of rhubarb, combined with low dose continuous gastrointestinal dialysis in treating uremia. Methods: Patients of uremia were divided into three groups at random, 18 patients in group A were treated with 1000 ml gastrointestinal dialysate (non-absorbed mannitol solution) orally 2-3 times a day, 20 patients in group B treated with the same therapy as that in group A, also combined with XQN 5-10 tablets 3 times per day and 19 patients in group C treated with orally taken coated aldehyde oxystarch 5-10 g, 3 times a day. The therapeutic course for the three groups was 11 months. The changes in clinical manifestation, renal function, nutritional condition, and electrolytes before and after treatment were observed. Results: After treatment, significant improvement was revealed in aspects of uremic symptoms, quality of life, nutritional condition, serum creatinine, urea nitrogen, serum phosphate, uric acid, CO2 combining power, creatine clearance, body weight and arm muscular circumference in group A and B, as compared with those in group C. In comparison of group A with B, group B showed a lower serum triglyceride and a slower progression of chronic renal failure (CRF). All the criteria were not improved in group C and with serum creatinine being raised significantly. Conclusion: XQN combined with low dose continuous gastrointestinal dialysis therapy was definitely effective in treating uremia. It provides a new therapeutic means of non-replacement therapy for CRF with uremia.

  20. Cardiac manifestations of idiopathic pulmonary fibrosis

    OpenAIRE

    Agrawal, Abhinav; Verma, Isha; Shah, Varun; Agarwal, Abhishek; Sikachi, Rutuja R

    2016-01-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, parenchymal disease of the lung with an estimated prevalence of 14–43 per 100,000. Patient usually presents with coughing and exertional dyspnea, which can lead to acute respiratory failure. IPF has been associated with various co-morbidities such as lung cancer, emphysema, obstructive sleep apnea (OSA), GERD and multiple cardiovascular consequences. The cardiovascular manifestations of IPF include pulmonary hypertension, heart fa...

  1. Uncommon cutaneous manifestations of lupus erythematosus.

    Science.gov (United States)

    Mascaro, J M; Herrero, C; Hausmann, G

    1997-01-01

    Cutaneous manifestations of lupus erythematosus (LE) are, usually, characteristic enough to permit an easy diagnosis. However, some patients may present less typical lesions, associated or not to the classic ones. Therefore, irrespectively of the variety of LE (acute, subacute and chronic), in absence of the typical butterfly rash, erythematosquamous papules or plaques, or any of the characteristic cutaneous alterations, it is important (even though not always easy) to recognize the uncommon and/or atypical changes of the skin.

  2. A rare manifestation of tuberculosis: Scrofuloderma

    Directory of Open Access Journals (Sweden)

    Savaş Öztürk

    2011-03-01

    Full Text Available Scrofuloderma is a cutaneous manifestation of tuberculosis that results from direct extension of an underlying tuberculous focus, such as lymph node to the overlying skin. In this article, 16-year-old male patient, live in a child detention home, with a purulent, ulcerated lesion in his neck, diagnosed as Scrofuloderma was presented. The case presented in order to stress that Scrofuloderma, a rare form of tuberculosis, should be kept in mind in the differential diagnosis of chronic skin lesions.

  3. A REVIEW OF GASTROINTESTINAL DISORDERS IN PATIENTS WITH PRIMARY ANTIBODY IMMUNODEFICIENCIES DURING A 10 YEAR PERIOD (1990-2000,IN CHILDREN HOSPITAL MEDICAL CENTER

    Directory of Open Access Journals (Sweden)

    Lida Atarod

    2003-06-01

    Full Text Available One of the most prevalent manifestations of primary antibody deficiencies is gastrointestinal disorders.In this study we reviewed 83 patients including 25 with X-Linked agamma¬globulinemia. 40 with common variable immunodeficiency, 14 with IgA defi¬ciency and 4 with IgG subclass deficiency. The mean age of patients was 10 year (l-28yr. The ratio of male to female was 1.5.Gastrointestinal system was affected in more than half (57.8% of them. The most common symptom was diarrhea (56.6%o and the most prevalent pathogen was. G. Lamblia.Other disorders were chronic active hepatitis in 6 patients, ulcerative colitis in 2, small intestinal villus atrophy in 5, nodular lymphoid hyperplasia of small in¬testine in 3 and chronic gastritis in 4 patients. One patient suffered from abdomi¬nal lymphoma.We found a direct correlation between failure of patients to thrive and the duration of the delay in diagnosing the underlying disease. This difference was more apparent in those with both antibody deficiency and gastrointestinal involve¬ment.

  4. Multiple giant diverticula of the foregut causing upper gastrointestinal obstruction

    Institute of Scientific and Technical Information of China (English)

    Genoveffa Balducci; Mario Dente; Giulia Cosenza; Paolo Mercantini; Pier Federico Salvi

    2008-01-01

    Small bowel diverticulosis represents an uncommon disorder (except for Meckel diverticulum) often misdiagnosed since it causes non-specific gastrointestinal symptoms.Most of times the diagnosis is carried out in case of related complications,such as diverticulitis,hemorrhage,perforation or obstruction.Intestinal obstruction can be caused by inflammatory stenosis due to repeated episodes of diverticulitis,volvulus,intussusception or jejunal stones.Herein we report a case of multiple jejunal diverticula causing chronic gastrointestinal obstruction.

  5. Endocrine manifestations of celiac disease

    Directory of Open Access Journals (Sweden)

    R Philip

    2012-01-01

    Full Text Available Background: Celiac disease can have extra gastrointestinal tract (GIT presentations, most of which are endocrine. The aim of this study was to present patients diagnosed to have celiac disease from an endocrine department and to study the prevalence of endocrinopathies in celiac disease. Materials and Methods: A total of 36 patients from the endocrinology department (LLRM Medical College, Meerut between January 2011 and July 2012 and who were diagnosed to have celiac disease were included in the study. Results: Short stature was the commonest presentation (25%, other presentations included short stature and delayed puberty (20%, delayed puberty (11%, screening for celiac disease in type-1 DM patients (17%, rickets (6%, anemia not responding to oral therapy (6%, type-1 DM with recurrent hypoglycaemia (6%, and osteomalacia (3%. The endocrine manifestations include (after complete evaluation short stature (58%, delayed puberty (31%, elevated alkaline phospahatase (67%, low calcium (22%, X-rays suggestive of osteomalacia or rickets (8%, capopedal spasm (6%, and night blindness (6%. Anti-TPO antibody positivity was found in 53%, hypothyroidism in 28%, subclinical hypothyroidism in 17%, and type-1 DM in 25% of the patients. A total of 14% patients had no GI symptoms. Conclusion: Celiac disease is an endocrine disrupter as well as the great masquerader having varied presentations including short stature, delayed puberty, and rickets. Some patients who have celiac disease may not have any GI symptoms, making the diagnosis all the more difficult. Also, there is significant incidence of celiac disease with hypothyroidism and type-1 DM, making screening for it important in these diseases.

  6. Neuromuscular disorders in chronic alcohol intoxication

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  7. Endoscopic Gastrointestinal Laser Therapy

    OpenAIRE

    Buchi, Kenneth N.

    1985-01-01

    The development of flexible fibers for the delivery of laser energy led to the first endoscopic laser applications in humans in the early 1970s. Since that time, much has been learned about applications throughout the gastrointestinal tract. The risks appear to be minimal. The coagulative effect of laser energy is used to treat gastrointestinal hemorrhage and small, benign mucosal lesions. The ablative effect of the Nd:YAG laser on tissue is used for palliative therapy for malignant gastroint...

  8. Gastrointestinal motility and functional gastrointestinal diseases.

    Science.gov (United States)

    Kusano, Motoyasu; Hosaka, Hiroko; Kawada, Akiyo; Kuribayashi, Shiko; Shimoyama, Yasuyuki; Zai, Hiroaki; Kawamura, Osamu; Yamada, Masanobu

    2014-01-01

    Digestive tract motility patterns are closely related to the pathophysiology of functional gastrointestinal diseases (FGID), and these patterns differ markedly between the interdigestive period and the postprandial period. The characteristic motility pattern in the interdigestive period is so-called interdigestive migrating contraction (IMC). IMCs have a housekeeping role in the intestinal tract, and could also be related to FGID. IMCs arising from the stomach are called gastrointestinal IMCs (GI-IMC), while IMCs arising from the duodenum without associated gastric contractions are called intestinal IMCs (I-IMC). It is thought that I-IMCs are abnormal in FGID. Transport of food residue to the duodenum via gastric emptying is one of the most important postprandial functions of the stomach. In patients with functional dyspepsia (FD), abnormal gastric emptying is a possible mechanism of gastric dysfunction. Accordingly, delayed gastric emptying has attracted attention, with prokinetic agents and herbal medicines often being administered in Japan to accelerate gastric emptying in patients who have anorexia associated with dyspepsia. Recently, we found that addition of monosodium L-glutamate (MSG) to a high-calorie liquid diet rich in casein promoted gastric emptying in healthy men. Therefore, another potential method of improving delayed gastric emptying could be activation of chemosensors that stimulate the autonomic nervous system of the gastrointestinal tract, suggesting a role for MSG in the management of delayed gastric emptying in patients with FD.

  9. Chronic pelvic pain: comorbidity between chronic musculoskeletal pain and vulvodynia

    Directory of Open Access Journals (Sweden)

    G. Biasi

    2014-06-01

    Full Text Available Chronic pelvic pain (CPP is a common condition that has a major impact on the quality of life of both men and women. Male CPP is usually attributable to well-defined urogenital conditions (most frequently infectious/non infectious prostatic diseases or musculoskeletal or bowel diseases, whereas the features of female CPP are much more complex and are of particular clinical and epidemiological importance. It is a multifactorial syndrome that can be due to diseases of the urogenital, gastrointestinal, or musculoskeletal systems, or to neurological or neuropsychiatric disorders. It is not always easy to identify its predominant pathogenesis, although it often occurs as a central sensitization syndrome triggered by an initial stimulus which is no longer detectable and only manifests itself clinically through pain. In this respect, there are some very interesting relationships between vulvodynia and fibromyalgic syndrome, as identified in a preliminary study of women with chronic musculoskeletal pain in which it was demonstrated that vulvar pain plays an important role, although it is often overlooked and undiagnosed.

  10. A Clinico- Epidemiological Study Of Filarial Related Orthopaedic Manifestations

    Directory of Open Access Journals (Sweden)

    Patond K.R

    1992-01-01

    Full Text Available An epidemiological study was undertaken to study the incidence and distribution of orthopaedic manifestations of filariasis in an endemic area. A total of 207 cases were clinically examined and investigated. Patients were divided into three groups , viz., Group A: Orthopaedic manifestations with no history of filariasis . Group B: Orthopaedic manifestations with history of filariasis such as microfilaraemia or filarial fevers etc., Group C: Orthopaedic manifestations with chronic manifestations such as elephantiasis, hydrocele etc. To confirm filarial etiology, all the cases were examined for the presence of filarial antibody by indirect ELISA using wuchereda bancrofti microfilarial excretory- secretary antigen (wd Mf ESAg . A total of 61 of 102 patients of Group A, 14 of 21 patients of group B, and 73 of 84 patients of Group C were positive for filarial antibody. This study showed the prevalence of filarial antibody in about 71.4% of various orthopaedic manifestations.

  11. MANIFEST OF DEPTH SOCIOPSYCHOLOGY

    OpenAIRE

    ZELITCHENKO ALEXANDER

    2013-01-01

    The observations of motives of activity of big groups (nations, confessions etc.) as a whole result in discovery of the part of unconscious mind that is common for all members of big group a collective unconscious. Two parts of collective unconscious may be determined: the collective superconscious known first as a group archetype and the collective subconscious, which manifest itself for example in phenomenon of collective trauma. Depth sociopsychology is a science about the collective uncon...

  12. Synchronous Acromegaly and Gastrointestinal Stromal Tumor: A Case Report

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    Hüsniye Başer

    2014-06-01

    Full Text Available Acromegaly is a rare endocrine disorder characterized by the manifestations of sustained hypersecretion of growth hormone and concomitant elevations in circulating concentrations of insulin-like growth factor-1. It has been reported that patients with acromegaly are at the increased risk of developing malignant tumors, particularly colorectal cancer. Gastrointestinal stromal tumors are mesenchymal tumors of the digestive tract. An association between gastrointestinal stromal tumors and insulin-like growth factor system has been reported. Here, we report a patient diagnosed with synchronous acromegaly and gastrointestinal stromal tumor. A 59-year-old man with iron deficiency anemia presented with enlarged hands, coarse facial feature and several skin tags. Thyroid function tests were within normal range. Growth hormone was 5.14 ng/mL, insulin-like growth factor-1 was 820 ng/mL, and no growth hormone suppression was observed on 75g oral glucose tolerance test. Pituitary magnetic resonance imaging revealed microadenoma, and the patient was diagnosed with acromegaly. Upper gastrointestinal tract endoscopy revealed an ulcerovegetan mass in the duodenum and the results of the histopathologcal analysis was consistent with gastrointestinal stromal tumor. The association of synchronous and asynchronous gastrointestinal stromal tumors with other malignancies have been reported. The most common accompanying neoplasms are colorectal and gastric adenocarcinomas, as well as pancreatic tumors. However, in the literature, the number of reported cases of synchronous acromegaly and gastrointestinal stromal tumor are limited, and there are no sufficient data on this association. Turk Jem 2014; 2: 52-55

  13. Ocular manifestations of leptospirosis

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    Rathinam S

    2005-01-01

    Full Text Available Leptospiral uveitis is a common entity in tropical countries. Ocular manifestations are noted in the second phase of illness, but these remain under-diagnosed mainly because of the prolonged symptom-free period that separates the systemic manifestations from detection of ocular manifestations.Varying ophthalmic presentations and the intrinsic nature of different types of uveitis to mimic one another also challenge the accuracy of the diagnosis. Of the individual ocular signs, the combination of acute, non-granulomatous, panuveitis, hypopyon, vasculitis, optic disc edema, membranous vitreous opacities and absence of choroiditis or retinitis have high predictive value for the clinical diagnosis of leptospiral uveitis. Geographic location of the patient, occupation, socio-economic status, risk factors related to exposure, past history of fever or jaundice also aid in diagnosis.Steroids are the mainstay of treatment for leptospiral uveitis. Depending upon the severity and anatomical location of inflammatory lesion, topical, peri-ocular and/or systemic steroids are given. The prognosis is generally good, even when the inflammation is severe.

  14. Unusual manifestation of Erdheim-Chester disease

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    Schlup Martin

    2011-06-01

    Full Text Available Abstract Background Erdheim-Chester disease (ECD is a rare multisystem non-Langerhans cell histiocytosis that is characterized histologically by xanthogranulomatous infiltrates and radiologically by symmetrical sclerosis of long bones. The xanthomatous process is characterized by prominent foamy histiocytes staining positive for CD68, occasionally for PS100 and negative for S100 and CD1a. Gastroenterological involvement is exceedingly rare. Case Presentation This case report describes the case of a 69-year-old man who presented otherwise well to the gastroenterology department with unspecific abdominal symptoms, nausea, vomiting and weight loss. ECD involving the gastrointestinal tract was confirmed clinically, radiologically and histologically. Conclusion Gastroenterological manifestation of ECD is rare but should be considered in the differential diagnosis in patients presenting with evidence of multi-organ disease and typical radiological features of Erdheim-Chester disease elsewhere.

  15. Radiologic imaging of congenital gastrointestinal anomalies in infants

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    Leny Zabidi

    2014-11-01

    Full Text Available Background Congenital gastrointestinal anomalies may manifest signs or symptoms in the first few days of life, most commonly in the form of obstructions. Radiologic imaging plays an important role in diagnosis confirmation and surgical correction plans. Most cases may be diagnosed by plain radiographs alone, but CT scans and MRI may be needed to make accurate diagnoses, especially in difficult cases. Objective To report radiologic imaging findings in infants with congenital gastrointestinal anomalies. Methods For this retrospective, cross-sectional study we took secondary data from medical records of infants with congenital gastrointestinal anomalies in Dr. Kariadi Hospital, Semarang, Indonesia from January 2010 – June 2011. Diagnosis of congenital anomalies was confirmed by clinical manifestation and radiologic imaging. Radiologic findings were reviewed by a single radiologist on duty at that time. Data is presented in the form of frequency distribution. Results Subjects consisted of 50 males and 23 females. The most common complaints were vomiting in 14 subjects (19%, abdominal distension in 31 subjects (43%, and fecal passage dysfunction in 28 subjects (38%. Radiologic imaging of subjects with congenital gastrointestinal anomalies revealed the following conditions: anal atresia in 28 subjects (38%, congenital megacolon in 21 subjects (29%, esophageal atresia in 14 subjects (19%, duodenal atresia in 9 subjects (12%, and pyloric atresia in 1 subject (2%. Conclusion Using radiologic imaging of infants with congenital gastrointestinal anomalies, the most to least common conditions found were anal atresia, congenital megacolon, esophageal atresia, duodenal atresia, and pyloric atresia.

  16. Obesity and gastrointestinal neoplasms

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    Izabela Binkowska-Borgosz

    2014-10-01

    Full Text Available Being overweight or obese is a significant public health problem in the 21st century due to its scale, common existence and its cause-effect association with multiple diseases. Excessive accumulation of adipose tissue in humans is regarded as a major risk factor for development of cardiovascular and skeletal diseases. However, data from recent years have revealed that obesity is also strongly associated with increased risk of the majority of cancers in humans, including those originating from the gastrointestinal tract. During the last few year this association has been thoroughly proven and supported by several epidemiological analyses. The authors present i the current state of knowledge regarding key (pathomechanisms that link metabolism of human adipose tissue to development/progression of neoplasms (especially in the gastrointestinal tract, as well as ii the results of selected clinical studies in which the influence of obesity on risk of gastrointestinal cancer development has been addressed.

  17. Radiological manifestations of melioidosis

    International Nuclear Information System (INIS)

    Melioidosis is a serious infection that is associated with high mortality. It is due to a Gram-negative bacterium, Burkholderia pseudomallei which is an environmental saprophyte found in wet soils. Melioidosis is endemic to northern Australia and the Southeast Asia. However, there is now increasing number of reports of imported cases to regions where this infection has not been previously encountered. Almost any organ can be affected. Like many other conditions, radiological imaging is an integral part of the diagnostic workup of melioidosis. Awareness of the various radiological manifestations can help direct appropriate investigations to achieve early diagnosis and the initiation of appropriate treatment. Generally, there are no known characteristic features on imaging that can specifically differentiate melioidosis from other infections. However, the 'honeycomb' appearance has been described to be characteristic for large melioidosis liver abscesses. Simultaneous involvement of various organs is also characteristics. To date, there are few data available on the radiological manifestations of melioidosis. The present pictorial essay describes melioidosis affecting the various organs.

  18. Heritable Gastrointestinal Cancer Syndromes.

    Science.gov (United States)

    Stoffel, Elena M

    2016-09-01

    Although almost all gastrointestinal cancers develop from sporadic genomic events, approximately 5% arise from germline mutations in genes associated with cancer predisposition. The number of these genes continues to increase. Tumor phenotypes and family history provide the framework for identifying at-risk individuals. The diagnosis of a hereditary cancer syndrome has implications for management of patients and their families. Systematic approaches that integrate family history and molecular characterization of tumors and polyps facilitate identification of individuals with this genetic predisposition. This article summarizes diagnosis and management of hereditary cancer syndromes associated with gastrointestinal cancers. PMID:27546846

  19. Sinonasal Manifestations in Cystic Fibrosis

    OpenAIRE

    Oomen, Karin P. Q.; Max M. April

    2012-01-01

    Cystic fibrosis is a genetic disease, characterized by accumulation of thickened mucous secretions in exocrine glands. Although the major clinical manifestations of the disease are pancreatic and pulmonary disease, the majority of cystic fibrosis patients will develop sinonasal manifestations as well. This paper outlines the etiology, evaluation, and management of the nasal and sinus manifestations in patients with cystic fibrosis.

  20. 消化道出血概述%Overview of Gastrointestinal Bleeding

    Institute of Scientific and Technical Information of China (English)

    刘文忠

    2015-01-01

    消化道出血是急诊科和消化科常见的临床病况之一。急性大量出血可危及生命,慢性失血可产生贫血症状,部分消化道出血是一些严重疾病,包括胃肠道恶性肿瘤的临床表现。熟悉和掌握消化道出血的临床表现、分类和处理原则,将有助于提高其预防和治疗水平。%Gastrointestinal(GI)bleeding is one of the commonly seen clinical problems in departments of emergency and gastroenterology. Acute massive bleeding may be life-threatening,and chronic blood loss can present symptoms of anemia. GI bleeding is the clinical manifestation of some serious diseases,including GI malignancies. Familiar with and mastering the clinical manifestations,classification and principles of management of GI bleeding will help to improve its prevention and treatment.

  1. NEUROLOGIC MANIFESTATION OF ORGANIC ACADEMIA

    Directory of Open Access Journals (Sweden)

    Seyyed Hassan TONEKABONI

    2012-03-01

    Full Text Available Inborn errors of organic acid metabolism are relatively recently recognized diseases with a wide spectrum of clinical signs and symptoms: ranging from asymptomatic, normal appearing children to death during first few days of life.In my presentation I will try to explain some of the most common clinical presentation of these disorder with stress on neurologic findings. Organic acidemia usually have three clinical manifestations Severe neonatal form, Intermittent late-onset form and chronic progressive form. Recurrent coma, The main feature of these disorders is due to accumulation of toxic metabolites in Central Nervous system with direct effect on the function, while chronic accumulation of these materials may interfere with CNS development or cerebral metabolism leading to developmental delay.Severe neonatal formsFollowing a symptom free interval of a few days from birth, poor sucking and difficult feeding appears in the newborn, followed by unexplained and progressive coma. Seizures may appear during the course of the disease and EEG may show a burst-suppression pattern. During this stage most infants have axial hypotonia with peripheral dystonia, choreoathetosis, episodic opisthotonus and some repetitive bicycling and boxing movements.Associated biochemical abnormalities including metabolic acidosis, ketonuria and hyperammonemia also is usually present. The overall short-term prognosis with recent advances in medical care is improving. But later in life acute intercurrent episodes triggered by a stress often occur, which can be occasionally fatal.bulging fontanelle and cerebral edema may mimic CNS infection in these babies.Intermittent late-onset formsRecurrent attacks of coma or lethargy with ataxia can occur in childhood or even in adolescence or adulthood. These episodes may be frequent, though in between these the child is entirely normal. These attacks are precipitated by conditions that enhance protein catabolism (trauma, infection etc

  2. Cardiac manifestations of idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Agrawal, Abhinav; Verma, Isha; Shah, Varun; Agarwal, Abhishek; Sikachi, Rutuja R

    2016-05-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, parenchymal disease of the lung with an estimated prevalence of 14-43 per 100,000. Patient usually presents with coughing and exertional dyspnea, which can lead to acute respiratory failure. IPF has been associated with various co-morbidities such as lung cancer, emphysema, obstructive sleep apnea (OSA), GERD and multiple cardiovascular consequences. The cardiovascular manifestations of IPF include pulmonary hypertension, heart failure, coronary artery disease, cardiac arrhythmias & cardiac manifestations of drugs used to treat IPF. This review will outline evidence of the association between IPF and cardiovascular conditions and attempt to provide insights into the underlying pathophysiology. We also discuss the impact of these cardiovascular diseases on patients with IPF including increased morbidity and mortality. PMID:27195188

  3. [Cerebrotendinous xanthomatosis: physiopathology, clinical manifestations and genetics].

    Science.gov (United States)

    Preiss, Yudith; Santos, José L; Smalley, Susan V; Maiz, Alberto

    2014-05-01

    Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disease, caused by genetic deficiency of the 27-hydroxylase enzyme (encoded by CYP27A1). It plays a key role in cholesterol metabolism, especially in bile acid synthesis and in the 25-hydroxylation of vitamin D3 in the liver. Its deficiency causes reduced bile acid synthesis and tissue accumulation of cholestanol. Clinical manifestations are related to the presence of cholestanol deposits and include tendon xanthomas, premature cataracts, chronic diarrhea, progressive neurologic impairment and less frequently coronary heart disease, early onset osteoporosis and abnormalities in the optic disk and retina. An early diagnosis and treatment with quenodeoxycholic acid may prevent further complications, mainly neurological manifestations. This review summarizes cholesterol metabolism related to bile acid synthesis, physiopathology, biochemistry and treatment of cerebrotendinous xanthomatosis. PMID:25427019

  4. Pattern of cutaneous manifestations in diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Goyal Abhishek

    2010-01-01

    Full Text Available Background: Diabetes mellitus affects individuals of all ages and socioeconomic status. Skin is affected by the acute metabolic derangements as well as by chronic degenerative complications of diabetes. Aims: To evaluate the prevalence of skin manifestations in patients with diabetes mellitus. To analyze the prevalence and pattern of skin disorders among diabetic patients from this region of Western Himalayas. Materials and Methods: One hundred consecutive patients with the diagnosis of diabetes mellitus and having skin lesions, either attending the diabetic clinic or admitted in medical wards were included in this study. Results: The common skin disorders were: x0 erosis (44%, diabetic dermopathy (36%, skin tags (32%, cutaneous infections (31%, and seborrheic keratosis (30%. Conclusion: Skin is involved in diabetes quite often and the manifestations are numerous. High prevalence of xerosis in our diabetic population is perhaps due to cold and dry climatic conditions in the region for most of the time in the year.

  5. Acute dacryocystitis: another clinical manifestation of sporotrichosis

    Directory of Open Access Journals (Sweden)

    Dayvison Francis Saraiva Freitas

    2014-04-01

    Full Text Available Sporotrichosis associated with exposure to domestic cats is hyperendemic in Rio de Janeiro, Brazil. A review of the clinical records at our institute revealed four patients with clinical signs of dacryocystitis and a positive conjunctival culture for Sporothrix who were diagnosed with Sporothrix dacryocystitis. Three patients were children (< 13 years of age and one patient was an adult. Two patients reported contact with a cat that had sporotrichosis. Dacryocystitis was associated with nodular, ulcerated lesions on the face of one patient and with granulomatous conjunctivitis in two patients; however, this condition manifested as an isolated disease in another patient. All of the patients were cured of the fungal infections, but three patients had chronic dacryocystitis and one patient developed a cutaneous fistula. Sporotrichosis is usually a benign disease, but may cause severe complications when the eye and the adnexa are affected. Physicians, especially ophthalmologists in endemic areas, should be aware of the ophthalmological manifestations and complications of sporotrichosis.

  6. [Gastrointestinal and hepatic diseases].

    Science.gov (United States)

    Moctezuma-Velázquez, Carlos; Aguirre-Valadez, Jonathan

    2016-09-01

    Diet is considered an important triggering factor for gastrointestinal symptoms whose physiopathology includes not only measurable, inflammatory reactions, but also functional disorders, where no organic effects may be measured or demonstrated. Moreover, the prevalence of the perceived intolerance to certain foods ranges from 20-25% (within the general population) to 50-70% in diseases like irritable bowel syndrome. This intolerance has been observed particularly after the consumption of milk and dairy products, which are frequently considered as causative of gastrointestinal symptoms, thus limiting their ingestion. However, this behavior reduces the dietary sources of calcium and consequently may lead to malnutrition and bone decalcification, amongst other complications. The true dairy intolerance (intestinal lactase deficiency) explains most of the symptoms ensuing their consumption, but the frequency of such alteration on the different gastrointestinal diseases has not been determined. This review focuses on the most frequent gastrointestinal diseases and the existing evidence regarding the alterations and symptoms related to the consumption of milk or dairy products. PMID:27603892

  7. Manifesting the Quantum World

    Science.gov (United States)

    Mohrhoff, Ulrich

    2014-06-01

    In resisting attempts to explain the unity of a whole in terms of a multiplicity of interacting parts, quantum mechanics calls for an explanatory concept that proceeds in the opposite direction: from unity to multiplicity. Being part of the Scientific Image of the world, the theory concerns the process by which (the physical aspect of) what Sellars called the Manifest Image of the world comes into being. This process consists in the progressive differentiation of an intrinsically undifferentiated entity. By entering into reflexive spatial relations, this entity gives rise to (i) what looks like a multiplicity of relata if the reflexive quality of the relations is not taken into account, and (ii) what looks like a substantial expanse if the spatial quality of the relations is reified. If there is a distinctly quantum domain, it is a non-spatial and non-temporal dimension across which the transition from the unity of this entity to the multiplicity of the world takes place. Instead of being constituents of the physical world, subatomic particles, atoms, and molecules are instrumental in its manifestation. These conclusions are based on the following interpretive principle and its more direct consequences: whenever the calculation of probabilities calls for the addition of amplitudes, the distinctions we make between the alternatives lack objective reality. Applied to alternatives involving distinctions between regions of space, this principle implies that, owing to the indefiniteness of positions, the spatiotemporal differentiation of the physical world is incomplete: the existence of a real-valued spatiotemporal background is an unrealistic idealization. This guarantees the existence of observables whose values are real per se, as against "real by virtue of being indicated by the values of observables that are real per se." Applied to alternatives involving distinctions between things, it implies that, intrinsically, all fundamental particles are numerically

  8. Bugs on the brain; brain in the gut--seeking explanations for common gastrointestinal symptoms.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2013-03-01

    Gastrointestinal symptoms such as heartburn, indigestion (or dyspepsia), bloating, distension, constipation, abdominal pain, abdominal discomfort and diarrhoea are extremely common worldwide. For some, such symptoms can prove to be chronic and disabling.

  9. Late and chronic Lyme disease.

    Science.gov (United States)

    Donta, Sam T

    2002-03-01

    This article reviews the late and chronic manifestations of Lyme disease. Special attention is given to the chronic manifestations of the disease, detailing its pathogenesis, clinical spectrum, and laboratory criteria for the diagnosis. Based on experimental evidence and experience, approaches to the successful treatment of the late and chronic disease are outlined. Much additional work is needed to improve the understanding of the underlying pathophysiology of the disease, its diagnosis and treatment.

  10. Haemochromatosis and gastrointestinal cancer.

    Science.gov (United States)

    Lagergren, Katarina; Wahlin, Karl; Mattsson, Fredrik; Alderson, Derek; Lagergren, Jesper

    2016-10-15

    Iron overload in patients with haemochromatosis is a strong risk factor for liver cancer, but its influence on other gastrointestinal cancer risk is unclear. The aim was to assess the relative risk of luminal gastrointestinal cancer among patients diagnosed with haemochromatosis. This population-based, nationwide Swedish cohort study included patients with haemochromatosis in Sweden in 1965-2013. The incidence of gastrointestinal cancers was assessed through the Swedish Cancer Registry. The measure of relative risk was the standardised incidence ratio (SIR) with 95% confidence interval (CI), that is, the ratio of the observed number of gastrointestinal cancers in the haemochromatosis cohort divided by the expected number of such cancers, calculated from the entire corresponding background population of Sweden. Among 6,849 patients in the haemochromatosis cohort with up to 48 years of follow-up, the SIRs were 3-fold increased for oesophageal squamous cell carcinoma (SIR = 3.2, 95% CI 1.3-6.6; n = 7) and 40% increased for colon adenocarcinoma (SIR = 1.4, 95% CI 1.1-1.9; n = 54). No associations were found between haemochromatosis and the risk of adenocarcinoma of the oesophagus (SIR = 0.5, 95% CI 0.0-2.5; n = 1), stomach (SIR = 0.7, 95% CI 0.3-1.4; n = 8), small bowel (SIR = 1.2, 95% CI 0.0-6.7; n = 1) or rectum (SIR = 1.0, 95% CI 0.6-1.6; n = 21). These findings indicate that haemochromatosis increases the risk of oesophageal squamous cell carcinoma and colon adenocarcinoma, but might not influence the risk of other types of luminal gastrointestinal cancer. These findings should encourage further research examining the role of iron overload in cancer aetiology. PMID:27300578

  11. Manifestation of psoriasis in the oral cavity.

    Science.gov (United States)

    Fatahzadeh, Mahnaz

    2016-03-01

    Despite the common prevalence of cutaneous psoriasis, the existence of manifestations in the oral cavity is subject to controversy. In this article, dermatologic psoriasis is reviewed, and a patient with generalized, symptomatic oral mucosal erythema resembling atrophic candidiasis synchronous with flare of chronic skin psoriasis is described. Diagnostic work up and therapeutic response supported that these mucosal findings were the oral counterpart of cutaneous disease. Dental providers should be familiar with the signs and symptoms of oral psoriasis, institute appropriate preventive measures, and provide palliation directed at symptomatic oral changes of psoriasis. PMID:26665263

  12. New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases

    Institute of Scientific and Technical Information of China (English)

    Charles H Knowles; Joanne E Martin

    2009-01-01

    Gastrointestinal neuromuscular diseases are a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular (including interstitial cell of Cajal) dysfunction. Common to most of these diseases are symptoms of impaired motor activity which manifest as slowed or obstructed transit with or without evidence of transient or persistent radiological visceral dilatation. A variety of histopathological techniques and allied investigations are being increasingly applied to tissue biopsies from such patients. This review outlines some of the more recent advances in this field, particularly in the most contentious area of small bowel disease manifesting as intestinal pseudo-obstruction.

  13. Clinical manifestations of zinc deficiency.

    Science.gov (United States)

    Prasad, A S

    1985-01-01

    The essentiality of zinc for humans was recognized in the early 1960s. The causes of zinc deficiency include malnutrition, alcoholism, malabsorption, extensive burns, chronic debilitating disorders, chronic renal diseases, following uses of certain drugs such as penicillamine for Wilson's disease and diuretics in some cases, and genetic disorders such as acrodermatitis enteropathica and sickle cell disease. In pregnancy and during periods of growth the requirement of zinc is increased. The clinical manifestations in severe cases of zinc deficiency include bullous-pustular dermatitis, alopecia, diarrhea, emotional disorder, weight loss, intercurrent infections, hypogonadism in males; it is fatal if unrecognized and untreated. A moderate deficiency of zinc is characterized by growth retardation and delayed puberty in adolescents, hypogonadism in males, rough skin, poor appetite, mental lethargy, delayed wound healing, taste abnormalities, and abnormal dark adaptation. In mild cases of zinc deficiency in human subjects, we have observed oligospermia, slight weight loss, and hyperammonemia. Zinc is a growth factor. Its deficiency adversely affects growth in many animal species and humans. Inasmuch as zinc is needed for protein and DNA synthesis and for cell division, it is believed that the growth effect of zinc is related to its effect on protein synthesis. Whether or not zinc is required for the metabolism of somatomedin needs to be investigated in the future. Testicular functions are affected adversely as a result of zinc deficiency in both humans and experimental animals. This effect of zinc is at the end organ level; the hypothalamic-pituitary axis is intact in zinc-deficient subjects. Inasmuch as zinc is intimately involved in cell division, its deficiency may adversely affect testicular size and thus affect its functions. Zinc is required for the functions of several enzymes and whether or not it has an enzymatic role in steroidogenesis is not known at present

  14. New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics

    Institute of Scientific and Technical Information of China (English)

    Antonio; Damián; Sánchez-Capilla; Paloma; De; La; Torre-Rubio; Eduardo; Redondo-Cerezo

    2014-01-01

    Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem.

  15. Manifesting the Quantum World

    CERN Document Server

    Mohrhoff, Ulrich

    2014-01-01

    In resisting attempts to explain the unity of a whole in terms of a multiplicity of interacting parts, quantum mechanics calls for an explanatory concept that proceeds in the opposite direction: from unity to multiplicity. It concerns the process by which what Sellars called the Manifest Image of the world comes into being. This process consists in the progressive differentiation of an intrinsically undifferentiated entity. By entering into reflexive spatial relations, this gives rise to (i) what looks like a multiplicity of relata if the reflexive quality of the relations is not taken into account, and (ii) what looks like a substantial expanse if the spatial quality of the relations is reified. If there is a distinctly quantum domain, it is a non-spatial and non-temporal dimension across which the transition from the unity of this entity to the multiplicity of the world takes place. Instead of being constituents of the physical world, subatomic particles, atoms, and molecules are instrumental in its manifes...

  16. Pulmonary manifestation of leptospirosis

    Energy Technology Data Exchange (ETDEWEB)

    Im, Jung Gi; Yeon, Kyung Mo; Han, Man Chung; Kim, Chu Wan; Lee, Jung Sang; Kim, Suhng Gwon; Han, Yong Chol; Chang, Woo Hyun; Chi, Je Geun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-02-15

    Authors analysed and present chest X-ray findings of serologically proven leptospirosis from Seoul National University Hospital, either admitted or referred for serological verification, during recent 2 years. Radiological findings were correlated with the lung specimen findings of experimentally induced leptospirosis in guinea pig. The results are as follows: 1. 24 cases (56%) showed positive X-ray findings. 2. Predominant radiological patterns of involved lung were tiny dot, small nodule, rosette density in 11 cases, massive confluent consolidation in 4 cases, and diffuse ill-defined velly increased density in 9 cases. 3. Distribution of pulmonary lesions were bilateral (100%), non-lobar, non-segmental (95%), and there were conspicuous tendency of peripheral lung predominance. 4. Extrapulmonary manifestation, such as pleural effusion or cardiomegaly was rate. 5. Pulmonary lesions resolved completely usually 5 to 10 days after their appearance. 6. From the gross and microscopic findings of serially sacrificed guinea pig's lung and a case of autopsy, authors concluded that fine dot-like density in chest X-ray was due to paleolithic hemorrhage in intraalveolar space at initial stage, growing up to ressette density or confluent consolidation as the pathetic extends to surrounding lung forming purpura and coalescent hemorrhage.

  17. Oral Manifestations and Complications of Diabetes Mellitus: A review

    OpenAIRE

    Al-Maskari, Awatif Y.; Al-Maskari, Masoud Y; Al-Sudairy, Salem

    2011-01-01

    Diabetes mellitus is a chronic disease affecting all age groups. It is one of the leading causes of mortality and morbidity worldwide. Many chronic macrovascular and microvascular complications of diabetes have been reported in the literature with few reports about oral complications. This article aims to review and increase the awareness of oral manifestations and complications of diabetes mellitus and to stimulate research on the subject. It treats in depth some of the complications such as...

  18. [Zinc and gastrointestinal disorders].

    Science.gov (United States)

    Higashimura, Yasuki; Takagi, Tomohisa; Naito, Yuji

    2016-07-01

    Zinc, an essential trace element, affects immune responses, skin metabolism, hormone composition, and some sensory function, so that the deficiency presents various symptoms such as immunodeficiency and taste obstacle. Further, the zinc deficiency also considers as a risk of various diseases. Recent reports demonstrated that -20% of the Japanese population was marginally zinc deficiency, and over 25% of the global population is at high risk of zinc deficiency. In gastrointestinal disorders, zinc plays an important role in the healing of mucosal and epithelial damage. In fact, polaprezinc, a chelate compound of zinc and L-carnosine, has been used for the treatment of gastric ulcer and gastritis. We describe here the therapeutic effect of zinc on gastrointestinal disorders. PMID:27455800

  19. GASTROINTESTINAL STROMAL TUMOR (GIST

    Directory of Open Access Journals (Sweden)

    Luigi eTornillo

    2014-11-01

    Full Text Available Gastrointestinal stromal tumors are the most frequent mesenchymal tumors of the gastrointestinal tract. The discovery that these tumors, formerly thought of smooth muscle origin, are indeed better characterized by specific activating mutation in genes coding for the receptor tyrosine kinases CKIT and PDGFRA and that these mutations are strongly predictive for the response to targeted therapy with receptor tyrosine kinase inhibitors has made GISTs the typical example of the integration of basic molecular knowledge in the daily clinical activity. The information on the mutational status of these tumors is essential to predict (and subsequently to plan the therapy. As resistant cases are frequently wild-type, other possible oncogenic events, defining other entities, have been discovered (e.g. succinil dehydrogenase mutation/dysregulation, insuline growth factor expression, mutations in the RAS-RAF-MAPK pathway. The classification of disease must nowadays rely on the integration of the clinico-morphological characteristics with the molecular data.

  20. Radiology illustrated. Gastrointestinal tract

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn (ed.) [Seoul National University Hospital (Korea, Republic of). Dept. of Radiology

    2015-02-01

    Radiology Illustrated: Gastrointestinal Tract is the second of two volumes designed to provide clear and practical guidance on the diagnostic imaging of abdominal diseases. The book presents approximately 300 cases with 1500 carefully selected and categorized illustrations of gastrointestinal tract diseases, along with key text messages and tables that will help the reader easily to recall the relevant images as an aid to differential diagnosis., Essential points are summarized at the end of each text message to facilitate rapid review and learning. Additionally, brief descriptions of each clinical problem are provided, followed by case studies of both common and uncommon pathologies that illustrate the roles of the different imaging modalities, including ultrasound, radiography, computed tomography, and magnetic resonance imaging.

  1. Primary gastrointestinal lymphoma

    OpenAIRE

    Amir Aledavood; Mohammad Reza Ghavam Nasiri; Bahram Memar; Soodabeh Shahidsales; Hamid Reza Raziee; Kamran Ghafarzadegan; Samira Mohtashami

    2012-01-01

    Background: Extranodal lymphoma may arise anywhere outside lymph nodes mostly in the gastrointestinal (GI) tract as non-Hodgkin′s disease. We reviewed the clinicopathological features and treatment results of patients with primary GI lymphoma. Materials and Methods : A total number of 30 cases with primary GI lymphoma were included in this study. Patients referred to the Radiation Oncology Department of Omid Hospital (Mashhad, Iran) during a 5-year period (2006-11). Clinical, paraclinical, an...

  2. Gastrointestinal food allergies.

    Science.gov (United States)

    Heine, Ralf G

    2015-01-01

    Gastrointestinal food allergies present during early childhood with a diverse range of symptoms. Cow's milk, soy and wheat are the three most common gastrointestinal food allergens. Several clinical syndromes have been described, including food protein-induced enteropathy, proctocolitis and enterocolitis. In contrast with immediate, IgE-mediated food allergies, the onset of gastrointestinal symptoms is delayed for at least 1-2 hours after ingestion in non-IgE-mediated allergic disorders. The pathophysiology of these non-IgE-mediated allergic disorders is poorly understood, and useful in vitro markers are lacking. The results of the skin prick test or measurement of the food-specific serum IgE level is generally negative, although low-positive results may occur. Diagnosis therefore relies on the recognition of a particular clinical phenotype as well as the demonstration of clear clinical improvement after food allergen elimination and the re-emergence of symptoms upon challenge. There is a significant clinical overlap between non-IgE-mediated food allergy and several common paediatric gastroenterological conditions, which may lead to diagnostic confusion. The treatment of gastrointestinal food allergies requires the strict elimination of offending food allergens until tolerance has developed. In breast-fed infants, a maternal elimination diet is often sufficient to control symptoms. In formula-fed infants, treatment usually involves the use an extensively hydrolysed or amino acid-based formula. Apart from the use of hypoallergenic formulae, the solid diets of these children also need to be kept free of specific food allergens, as clinically indicated. The nutritional progress of infants and young children should be carefully monitored, and they should undergo ongoing, regular food protein elimination reassessments by cautious food challenges to monitor for possible tolerance development.

  3. The gastrointestinal endocrine system

    OpenAIRE

    Track, Norman S.

    1980-01-01

    Gastrointestinal endocrinology is the study of the hormonal regulation of digestion. A number of characterized polypeptide hormones have been localized in specific gastroenteropancreatic endocrine cells. The fact that some of these hormones are also found in nerve and brain cells has given rise to the concept of a gut-brain axis. The functional capacities of these endocrine cells are determined by their anatomic location; the luminal exposure of gastroenteric endocrine cells represents an add...

  4. Lower gastrointestinal endoscopies results

    Directory of Open Access Journals (Sweden)

    Ahmet Bozdağ

    2014-12-01

    Full Text Available Objectives: Endoscopic examinations have great potential in early diagnosis of colorectal adenomas and carcinomas with reducing to colorectal cancer incidence and mortality. We aimed to evaluate for diagnostic purposeful lower gastrointestinal endoscopic procedures in the second step state hospital retrospectively Methods: Between June 2010 and June 2013, we evaluated 278 patients with rectal bleeding, constipation and abdominal pain detected by lower gastrointestinal endoscopic procedures retrospectively. Results: The mean age of the patients was 54.8 ± 16.8 (15-90 year, respectively. 172 (61.9% of the patients were male and 106 (38.1% of the patients were female. 116 (41.7% of the patients was performed rectosigmoidoscopy and 162 (58.3% of the patients was performed colonoscopy. 51(18.3% of our patients were normal. 10 (3.6% of patients had colorectal cancer, 11(3.9% of patients had inflammatory bowel disease, 8 (2.9% of patients had parasitosis, 31(11.1% of patients had colorectal polyps, 12 (4.3% , in patients had diverticular disease, 2 (0.7% patients had rectal ulcer, 25 (9% patients had anal fissure and 159 (57.2% of the patients had hemorrhoidal disease. Conclusion: Lower gastrointestinal endoscopy is a method been the gold standard with a low complication rate and that can be easily applied in the evaluation to pathology of colorectal and anal canal. J Clin Exp Invest 2014; 5 (4: 580-582

  5. Clinical Characters of Gastrointestinal Lesions in Intestinal Behcet's Disease

    Institute of Scientific and Technical Information of China (English)

    Wei-bin Wang; Yu-pei Zhao; Lin Cong; Hao Jing; Quan Liao; Tai-ping Zhang

    2011-01-01

    Objective To investigate the clinical features, diagnosis methods, therapeutic principles of intestinal Behcet's disease.Methods The clinical data of 45 patients with confirmed intestinal Behcet's disease admitted to Peking Union Medical College Hospital from August 1998 to April 2010 were retrospectively analyzed.Results The clinical courses of patients with intestinal Behcet's disease were from 26 days to 33 years, and the average duration was 6.32±1.01 years. The appearance of extra-gastrointestinal symptoms was significantly earlier than that of gastrointestinal symptoms (7.35±1.39 years vs.3.24±0.82 years,P<0.05). The predominant gastrointestinal manifestations were right lower quadrant pain (95.56%) and hematochezia or melena (40.00%). Misdiagnosis occurred in 17 cases. In patients without systemic medicine therapy before surgery, the incidence of postoperative infection of incision site and abdominal cavity was significantly higher than that in those undergoing systemic medicine therapy (80.00% vs.0%, P<0.05).Conclusions Because of the diversity of gastrointestinal manifestations, intestinal Behcet's disease is easily misdiagnosed. The systemic medical therapy before surgery could decrease the incidence of infection of incision and abdominal cavity.

  6. Respiratory manifestations in amyloidosis

    Institute of Scientific and Technical Information of China (English)

    XU Ling; CAI Bai-qiang; ZHONG Xu; ZHU Yuan-jue

    2005-01-01

    Background Amyloidosis is a collection of diseases in which different proteins are deposited. Amyloid deposits occur in systemic and organ-limited forms. In both systemic and localized forms of the disease, lung can be involved. The aim of this study was to explore the different respiratory manifestations of amyloidosis. Methods Chest radiology, clinical presentations, bronchoscopic/laryngoscopic findings and lung function data of 59 patients with amyloidosis involving respiratory tract collected during January 1986 to March 2005, were analysed.Results Of the 16 cases with localized respiratory tract amyloidosis, 8 had the lesions in the trachea and the bronchi, 2 in the larynx and the trachea, 5 in the larynx and/or the pharynx, and 1 in the lung parenchyma. Of 43 systemic amyloidosis with respiratory tract involvement, 3 had the lesions in bronchi, 13 in lung parenchyma, 33 in pleura, 8 in mediastina, 1 in nose and 1 in pharynx. Chest X-rays were normal in most cases of tracheobronchial amyloidosis. CT, unlike chest X-rays, showed irregular luminal narrowing, airway wall thickening with calcifications and soft tissue shadows in airway lumen. Localized lung parenchymal amyloidosis presented as multiple nodules. Multiple nodular opacities, patch shadows and reticular opacities were the main radiological findings in systemic amyloidosis with lung parenchymal involvement. In pleural amyloidosis, pleural effusions and pleural thickening were detected. Mediastinal and/or hilar adenopathy were also a form of lung involvement in systemic amyloidosis. The major bronchoscopic findings of tracheobronchial amyloidosis were narrowing of airway lumen, while nodular, 'tumour like' or 'bubble like' masses, with missing or vague cartilaginous rings, were detected in about half of the patients.Conclusions Localized respiratory tract amyloidosis mostly affects the trachea and the bronchi. Chest X-rays are not sensitive to detect these lesions. Systemic amyloidosis often involves

  7. ADAM Proteases and Gastrointestinal Function.

    Science.gov (United States)

    Jones, Jennifer C; Rustagi, Shelly; Dempsey, Peter J

    2016-01-01

    A disintegrin and metalloproteinases (ADAMs) are a family of cell surface proteases that regulate diverse cellular functions, including cell adhesion, migration, cellular signaling, and proteolysis. Proteolytically active ADAMs are responsible for ectodomain shedding of membrane-associated proteins. ADAMs rapidly modulate key cell signaling pathways in response to changes in the extracellular environment (e.g., inflammation) and play a central role in coordinating intercellular communication within the local microenvironment. ADAM10 and ADAM17 are the most studied members of the ADAM family in the gastrointestinal tract. ADAMs regulate many cellular processes associated with intestinal development, cell fate specification, and the maintenance of intestinal stem cell/progenitor populations. Several signaling pathway molecules that undergo ectodomain shedding by ADAMs [e.g., ligands and receptors from epidermal growth factor receptor (EGFR)/ErbB and tumor necrosis factor α (TNFα) receptor (TNFR) families] help drive and control intestinal inflammation and injury/repair responses. Dysregulation of these processes through aberrant ADAM expression or sustained ADAM activity is linked to chronic inflammation, inflammation-associated cancer, and tumorigenesis.

  8. ADAM Proteases and Gastrointestinal Function

    Science.gov (United States)

    Jones, Jennifer C.; Rustagi, Shelly; Dempsey, Peter J.

    2016-01-01

    A disintegrin and metalloproteinases (ADAMs) are a family of cell surface proteases that regulate diverse cellular functions, including cell adhesion, migration, cellular signaling, and proteolysis. Proteolytically active ADAMs are responsible for ectodomain shedding of membrane-associated proteins. ADAMs rapidly modulate key cell signaling pathways in response to changes in the extracellular environment (e.g., inflammation) and play a central role in coordinating intercellular communication within the local microenvironment. ADAM10 and ADAM17 are the most studied members of the ADAM family in the gastrointestinal tract. ADAMs regulate many cellular processes associated with intestinal development, cell fate specification, and the maintenance of intestinal stem cell/progenitor populations. Several signaling pathway molecules that undergo ectodomain shedding by ADAMs [e.g., ligands and receptors from epidermal growth factor receptor (EGFR)/ErbB and tumor necrosis factor α (TNFα) receptor (TNFR) families] help drive and control intestinal inflammation and injury/repair responses. Dysregulation of these processes through aberrant ADAM expression or sustained ADAM activity is linked to chronic inflammation, inflammation-associated cancer, and tumorigenesis. PMID:26667078

  9. ADAM Proteases and Gastrointestinal Function.

    Science.gov (United States)

    Jones, Jennifer C; Rustagi, Shelly; Dempsey, Peter J

    2016-01-01

    A disintegrin and metalloproteinases (ADAMs) are a family of cell surface proteases that regulate diverse cellular functions, including cell adhesion, migration, cellular signaling, and proteolysis. Proteolytically active ADAMs are responsible for ectodomain shedding of membrane-associated proteins. ADAMs rapidly modulate key cell signaling pathways in response to changes in the extracellular environment (e.g., inflammation) and play a central role in coordinating intercellular communication within the local microenvironment. ADAM10 and ADAM17 are the most studied members of the ADAM family in the gastrointestinal tract. ADAMs regulate many cellular processes associated with intestinal development, cell fate specification, and the maintenance of intestinal stem cell/progenitor populations. Several signaling pathway molecules that undergo ectodomain shedding by ADAMs [e.g., ligands and receptors from epidermal growth factor receptor (EGFR)/ErbB and tumor necrosis factor α (TNFα) receptor (TNFR) families] help drive and control intestinal inflammation and injury/repair responses. Dysregulation of these processes through aberrant ADAM expression or sustained ADAM activity is linked to chronic inflammation, inflammation-associated cancer, and tumorigenesis. PMID:26667078

  10. Duodenal duplication cyst that manifested as duodeno-jejunal intussusception in an adult: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hee Jin [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2007-08-15

    Duodenal duplication cyst account for 4% or 5% of all gastrointestinal duplications. Duodenal duplication acting as a lead point for an intussusception is an extremely rare event as it is largely a fixed retroperitoneal structure. We report here on the radiologic findings of a case of duodenal duplication cyst that manifested as duodeno-jejunal intussusception in an adult.

  11. Splenic arteriovenous malformation manifested by thrombocytopenia in hereditary hemorrhagic telangiectasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hee Jin; Choi, Jong Cheol; Oh, Jong Yeong; Cho, Jin Han; Kang, Myong Jin; Lee, Jin Hwa; Yoon, Seong Kuk; Nam, Kyeong Jin [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2008-09-15

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disease characterized by epistaxis, telangiectases and visceral arteriovenous malformations (AVMs). The involvement of the gastrointestinal tract, liver, lung and cerebrum for HHT has been described, whereas little is known about AVMs of the spleen. We report here the radiological findings of a case of a splenic AVM manifested by thrombocytopenia in HHT.

  12. Pulmonary manifestations of gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Gaude Gajanan

    2009-01-01

    Full Text Available Gastroesophageal reflux disease (GERD may cause, trigger or exacerbate many pulmonary diseases. The physiological link between GERD and pulmonary disease has been extensively studied in chronic cough and asthma. A primary care physician often encounters patients with extra esophageal manifestations of GERD in the absence of heartburn. Patients may present with symptoms involving the pulmonary system; noncardiac chest pain; and ear, nose and throat disorders. Local irritation in the esophagus can cause symptoms that vary from indigestion, like chest discomfort and abdominal pain, to coughing and wheezing. If the gastric acid reaches the back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs. The acid can cause throat irritation, postnasal drip and hoarseness, as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/ pneumonia. This clinical review examines the potential pathophysiological mechanisms of pulmonary manifestations of GERD. It also reviews relevant clinical information concerning GERD-related chronic cough and asthma. Finally, a potential management strategy for GERD in pulmonary patients is discussed.

  13. Neurologic and Head and Neck Manifestations of Sickle Cell Disease.

    Science.gov (United States)

    Steven, Andrew; Raghavan, Prashant; Rath, Tanya J; Gandhi, Dheeraj

    2016-08-01

    Sickle cell disease is a common, inherited disordered characterized by chronic hemolytic anemia with repetitive episodes of vasoocclusion resulting from deformed red blood cells. This article reviews the most significant neurologic and head and neck manifestations of this disease. PMID:27443997

  14. Cerebrovascular manifestations following scorpion sting

    Directory of Open Access Journals (Sweden)

    Nataraja P

    2016-07-01

    Full Text Available Scorpion sting is a common clinical problem in Rayalaseema area of Andhra Pradesh State in India. Clilnical presentation of scorpion envenomation can range from mild local pain to systemic manifestations involving almost all systems. Cerebrovascular manifestations of scorpion sting have been sparsely documented. We report two cases who presented with ischaemic stroke and haemorrhagic stroke following scorpion sting.

  15. Cerebrovascular manifestations following scorpion sting

    OpenAIRE

    Nataraja P; Naveen Prasad SV; Obulareddy G; Anil Ch; Naveen T; Vengamma B

    2016-01-01

    Scorpion sting is a common clinical problem in Rayalaseema area of Andhra Pradesh State in India. Clilnical presentation of scorpion envenomation can range from mild local pain to systemic manifestations involving almost all systems. Cerebrovascular manifestations of scorpion sting have been sparsely documented. We report two cases who presented with ischaemic stroke and haemorrhagic stroke following scorpion sting.

  16. Hyaline fibromatosis syndrome: cutaneous manifestations*

    Science.gov (United States)

    Marques, Silvio Alencar; Stolf, Hamilton Ometto; Polizel, Juliana Ocanha; Munhoz, Tânia; Brandão, Marcela Calixto; Marques, Mariangela Esther Alencar

    2016-01-01

    Hyaline fibromatosis syndrome is the current name for clinical manifestations of diseases previously known as “infantile systemic hyalinosis” and “juvenile hyaline fibromatosis”. The authors report representative clinical cases of each one of the above subtypes with emphasis on cutaneous manifestations and difficulties for early diagnosis in this syndrome, essentially of multidisciplinary approach. PMID:27192526

  17. 慢性肾脏病合并肺孢子菌肺炎胸部CT表现分析%Analysis of CT manifestations of pneumocystis pneumonia in patients with chronic kidney diseases

    Institute of Scientific and Technical Information of China (English)

    瞿华; 崔凤; 钟琦

    2016-01-01

    Objective To investigate the CT imaging features of pneumocystis pneumonia ( PCP ) in patients with chronic kidney diseases .Methods The CT images of 23 patients with PCP in chronic kidney diseases were analyzed retrospectively .Re-sults The CT images of PCP were shown as follous: patchy shadows and nodules , ground glass opacity , pulmonary consolida-tion, air containing cystic pattern, Fiber grid shadow, Mediastinal lymph node enlargement , angpleural effusion.The lesions pro-gressed gradually to diffuse ground glass and consolidation of the lung .Conclusion The CT images of PCP patients with chronic kidney diseases has its unique characteristics ,which has obvious value for the diagnosis of the disease .%目的:探讨慢性肾脏病合并肺孢子菌肺炎( PCP)的胸部CT表现特点。方法回顾分析2006年1月~2014年2月医院肾内科确诊的23例慢性肾脏病合并肺孢子菌患者的胸部CT影像资料。结果23例慢性肾脏病合并PCP患者的胸部CT表现主要有:斑片结节影、磨玻璃影、肺实变、肺气囊、纤维网格影、纵隔淋巴结肿大、胸腔积液。病变可表现为两肺或单侧肺。疾病早期以斑片结节影为主,逐渐进展呈弥漫磨玻璃及肺实变,伴有纤维网格影。结论慢性肾脏病合并肺孢子菌患者的胸部CT表现具有一定的特征性,对于该病的诊断具有明显的价值。

  18. Embolization for gastrointestinal hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J. [Dept. of Diagnostic Radiology, University of Ulm (Germany); Siech, M. [Dept. of Abdominal Surgery, University of Ulm (Germany)

    2000-05-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  19. Conventional radiological strategy of common gastrointestinal neoplasms

    Institute of Scientific and Technical Information of China (English)

    Yi-Zhuo; Li; Pei-Hong; Wu

    2015-01-01

    This article summarizes the clinical characteristics and imaging features of common gastrointestinal(GI) neoplasms in terms of conventional radiological imaging methods. Barium studies are readily available for displaying primary malignancies and are minimallyor not at all invasive. A neoplasm may be manifested as various imaging findings, including mucosal disruption, soft mass, ulcer, submucosal invasion and lumen stenosis on barium studies. Benign tumors typically appear as smoothly marginated intramural masses. Malignant neoplasms most often appear as irregular infiltrative lesions on barium examination. Tumor extension to adjacent GI segments may be indistinct on barium images. Cross-sectional images such as computed tomography and magnetic resonance imaging may provide more accurate details of the adjacent organ invasion, omental or peritoneal spread.

  20. Visceroptosis of the Bowel in the Hypermobility type of Ehlers-Danlos Syndrome: Presentation of a Rare Manifestation and Review of the Literature

    Science.gov (United States)

    Reinstein, Eyal; Pimentel, Mark; Pariani, Mitchel; Nemec, Stephen; Sokol, Thomas; Rimoin, David L

    2012-01-01

    Gastrointestinal complications are common in patients with Ehlers-Danlos Syndrome, affecting up to 50% of individuals depending on the subtype. The spectrum of gastrointestinal manifestations is broad and ranges from life threatening spontaneous perforation of the visceral organs to a more benign functional symptoms. Here we describe the clinical and radiographic manifestations of visceroptosis of the bowel, a rare complication of Ehlers-Danlos Syndrome that is characterized by prolapse of abdominal organs below their natural position. We further review the literature on gastrointestinal complications in the different forms of Ehlers-Danlos Syndrome. PMID:22781752

  1. Neonatal gastrointestinal imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Padma [Department of Radiology, Royal Children' s Hospital and University of Melbourne, Flemington Road, Parkville, Melbourne, Vic. 3052 (Australia)]. E-mail: padma.rao@rch.org.au

    2006-11-15

    Radiological imaging is an important part of the evaluation and management of neonates with suspected anomalies of the gastrointestinal tract. Clinical presentation is often non-specific, commonly with abdominal distension and vomiting for which the underlying cause may or may not be clinically apparent. In a proportion of patients, the clinical assessment alone may suffice in providing the diagnosis and no further imaging is necessary. The reader must have an understanding of the normal radiographic appearances of the gastrointestinal tract in neonates and appreciate normal variants and differences to adults. In certain cases, the abdominal radiograph alone is diagnostic. In others, sonography and contrast studies are useful adjunct investigations and the indications for CT and MRI are few, but specific. Appropriate radiological investigation will help to establish the diagnosis and guide surgical intervention whilst also avoiding unnecessary radiation. Some of the conditions require transfer to specialist paediatric institutions for care. Thus, in some circumstances it is appropriate for imaging to be delayed and performed at the specialist centre with early referral often essential for the continued well being of the child.

  2. Clinical manifestations of peripheral nervous system involvement in human chronic chagas disease Manifestaciones clinicas de compromiso del sistema nervioso periférico en el estádio crônico de la enfermedad de Chagas

    Directory of Open Access Journals (Sweden)

    Osvaldo Genovese

    1996-06-01

    Full Text Available We conducted a clinical and electromyographical study in patients with Chagas' disease in the indeterminate or chronic stages of the illness. Altogether 841 patients were examined. Only 511 were admitted within the protocol; the remainder patients were rejected because they showed other causes able to damage the nervous system. Fifty two (10.17% out of the 511 patients showed signs and symptoms of peripheral nervous system involvement in the form of sensory impairment and diminished tendon jerks suggesting the presence of neuropathy. Forty five of them were submitted to a conventional electromyographical examination. Fifteen of mem showed normal results, while the remainder 30 disclosed a reduced interference pattern, being most of the remaining motor unit potentials fragmented or poliphasic, reduced sensory and motor conduction velocities and diminished amplitude of the sensory action potential. The findings suggest that some chagasic patients in the indeterminate or chronic stages of the disease may develop a clinical mild sensory-motor peripheral neuropathy.El estúdio presente fue diseftado con ei objeto de pesquizar Ia existência de manifestaciones clinicas en pacientes afectados por enfermedad de Chagas, en estádio indeterminado o crônico, que tuviesen, ai menos, 2 reacciones serologicas positivas. En total fueron examinados 841 enfermos. De ellos solo 511 fueron admitidos en ei protocolo; los restantes fueron rechazados por mostrar Ia presencia de otras causas que hubiesen podido danar su sistema nervioso. Dentro de los 511 pacientes admitidos, 52 (10.17% evidenciaron alteraciones objetivas y subjetivas de Ia sensibilidad y disminucion de los reflejos osteotendinosos. Estos signos y sintomas, que sugieren la presencia de neuropatia, podian combinarse de diferente manera. Como complemento dei examen clinico, se efectuo estúdio electromiografico convencional en 45 de estos pacientes. En 15 los hallazgos fueron normales, en tanto que en

  3. [Serial episodes of gastric and cecal perforation in a patient with Behcet's disease involving the whole gastrointestinal tract: a case report].

    Science.gov (United States)

    Shin, Dong Yeob; Cheon, Jae Hee; Park, Jae Jun; Kim, Hoguen; Kim, Tae Il; Lee, Yong Chan; Kim, Nam Kyu; Kim, Won Ho

    2009-02-01

    Behcet's disease (BD) has been recognized as multi-systemic chronic vasculitic disorder of recurrent inflammation, characterized by the involvement of multiple organs and resulting in orogenital ulcers, uveitis, and skin lesions. Involvement of the central nervous system, vessels, and intestines in BD often leads to a poor prognosis. Digestive manifestations in BD have been reported in up to 1-60% of cases, although the rate varies in different countries. The most frequent extra-oral sites of gastrointestinal involvement are the ileocecal region and the colon. Gastric or esophageal involvement is reported to be very rare. Moreover, there have been no reports on the simultaneous involvement of the esophagus, stomach, ileum, and colon. Here, we present a 55-year-old Korean man with intestinal BD and multiple ileal and colonic ulcerations complicated by perforation, gastric ulcer with bleeding followed by perforation, and esophageal ulcers with bleeding.

  4. A retrospective analysis of ectopic varices in gastrointestinal tract diagnosed by endoscopy

    Institute of Scientific and Technical Information of China (English)

    李楠

    2013-01-01

    Objective To understand the incidence,causes,clinical manifestations and treatment of ectopic varices (EV) in gastrointestinal (GI) tract.Methods GI endoscopic examinations were carried out in 99 783 patients from January 2004 to October 2012 in General Hospital of PLA.Sixty-four cases of ectopic varices in GI tract were discovered.The clinical manifestations of EV patients and treatment were analyzed retrospectively.The

  5. The Cardiovascular Risk Profile of Atherosclerotic Gastrointestinal Ischemia Is Different from Other Vascular Beds

    NARCIS (Netherlands)

    Veenstra, Renzo P.; ter Steege, Rinze W. F.; Geelkerken, Robert H.; Huisman, Ad B.; Kolkman, Jeroen J.

    2012-01-01

    BACKGROUND: The distribution of cardiovascular risk factors in patients with chronic gastrointestinal ischemia due to atherosclerosis of the splanchnic vessels (chronic splanchnic syndrome) is not well studied. The aim of this study was to determine the cardiovascular risk factor pattern in patients

  6. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... Resources Young Adult Resources Family Support TSC Connect Publications & Information Sheets TSC Clinics Physician Referral TSC Clinical ... Presentations Clinical Manifestations Diagnostic Criteria TSC Consensus ... Clinical Trials Tissue Donation Professional Advisory Board Professional ...

  7. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... KIDNEY) MANIFESTATIONS IN TSC Download a PDF of this information. The majority of individuals (greater than 80 ... lead to bleeding. About 20% of the time this bleeding is life-threatening. Approximately 80 percent of ...

  8. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... Magazine Archives Life Stages Guides & Personal Journals TSC Research Article Summaries 2014 World TSC Conference Session Videos Research Teleconference Presentations Clinical Manifestations Diagnostic Criteria TSC Consensus ...

  9. Renal (Kidney) Manifestations in TSC

    Science.gov (United States)

    ... International TSC Research Conference Text Size Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of ... sclerosis complex (TSC) will develop some form of renal (kidney) disease during their lifetime. There are three ...

  10. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... Resources Young Adult Resources Family Support TSC Connect Publications & Information Sheets TSC Clinics Physician Referral TSC Clinical ... Presentations Clinical Manifestations Diagnostic Criteria TSC ... Clinical Trials Tissue Donation Professional Advisory Board Professional ...

  11. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of this information. The majority of individuals ( ... the least common renal association with TSC, is a cancerous growth of the kidney. Although it is ...

  12. Oral Manifestations of Secondary Syphilis

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Barbosa de Paulo

    2015-06-01

    Full Text Available Known as “the great imitator,” secondary syphilis may clinically manifest itself in myriad ways, involving different organs including the oral mucosa, and mimicking, both clinically and histologically, several diseases, thereby making diagnosis a challenge for clinicians. We highlight the clinical aspects of oral manifestation in 7 patients with secondary syphilis. Clinicians should consider secondary syphilis in the differential diagnosis of ulcerative and/or white oral lesions.

  13. Neurological manifestations of filarial infections.

    Science.gov (United States)

    Bhalla, Devender; Dumas, Michel; Preux, Pierre-Marie

    2013-01-01

    Filarial infections cause a huge public health burden wherever they are endemic. These filaria may locate anywhere in the human body. Their manifestations and pathogenic mechanisms, except the most common ones, are rarely investigated systematically. Their neurological manifestations, however, are being increasingly recognized particularly with onchocerciasis or Loa loa infections, Wuchereria bancrofti, or Mansonella perstans. The risk of developing these manifestations may also increase in cases that harbor multiple filariasis or coinfections, for instance as with Plasmodium. The microfilaria of Onchocerca and Loa loa are seen in cerebrospinal fluid. The pathogenesis of neurological manifestations of these infections is complex; however, pathogenic reactions may be caused by mechanical disruption, e.g., degeneration often followed by granulomas, causing fibrosis or mass effects on other tissues, vascular lesions, e.g., vascular block of cerebral vessels, or disordered inflammatory responses resulting in meningitis, encephalitis or localized inflammatory responses. The chances of having neurological manifestations may also depend upon the frequency and"heaviness"of infection over a lifetime. Hence, this type of infection should no longer be considered a disease of the commonly affected areas but one that may produce systemic effects or other manifestations, and these should be considered in populations where they are endemic. PMID:23829914

  14. Equine phacoclastic uveitis: the clinical manifestations, light microscopic findings, and therapy of 7 cases.

    OpenAIRE

    Grahn, B H; Cullen, C L

    2000-01-01

    This retrospective clinical study describes the clinical manifestations, light microscopic findings, and diagnosis and treatment of acute and chronic lens rupture in the horse. Rupture of the lens capsule in the horse usually results in a chronic, blinding inflammation (phacoclastic uveitis) unless prompt surgical and medical therapies are implemented. The clinical manifestations of acute lens capsule rupture included: cataract; intralenticular displacement of iridal pigment; lens cortical fr...

  15. Imaging of tuberculosis. Pt. 2. Abdominal manifestations in 112 patients

    Energy Technology Data Exchange (ETDEWEB)

    Lundstedt, C. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Nyman, R. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Brismar, J. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Hugosson, C. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Kagevi, I. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1996-07-01

    Purpose: To describe the radiological findings of tuberculosis (TB) of the abdomen as reflected at our hospital. Material and Methods: The radiological files of 503 patients (referred to our institution mainly because of a clinical suspicion of malignancy, and found to have culture- or biopsy-proven TB) were reviewed in order to analyze the spectrum of the TB manifestations in this group of patients. Results: Abdominal manifestations were found in 112 patients, in 1/3 abdominal disease was the only evidence of TB. More than half of the patients also had chest TB. The most common abdominal TB manifestations were peritonitis and lymph node enlargement, each occurring in about 1/3 of the patients. Also 1/3 had genitourinary TB manifestations. About 1/5 had TB of the liver, spleen or pancreas or in the gastrointestinal tract, respectively. Multiple organ involvement was common. Conclusion: The need to consider TB in the differential diagnosis in patients with obscure abdominal symptoms, especially with multiple organ involvement, is stressed. (orig.).

  16. Society of American Gastrointestinal and Endoscopic Surgeons

    Science.gov (United States)

    ... privileges for flexible gastrointestinal endoscopy. Privileging in flexible gastrointestinal endoscopy should be based on demonstration of competency in these techniques. Surgical Simulation: The Value of Individualization Surgical simulation ...

  17. Estrogen and gastrointestinal malignancy.

    LENUS (Irish Health Repository)

    Hogan, A M

    2012-02-01

    The concept that E2 exerts an effect on the gastrointestinal tract is not new and its actions on intestinal mucosa have been investigated for at least three decades. An attempt to consolidate results of these investigations generates more questions than answers, thus suggesting that many unexplored avenues remain and that the full capabilities of this steroid hormone are far from understood. Evidence of its role in esophageal, gastric and gallbladder cancers is confusing and often equivocal. The most compelling evidence regards the protective role conferred by estrogen (or perhaps ERbeta) against the development and proliferation of colon cancer. Not only has the effect been described but also many mechanisms of action have been explored. It is likely that, along with surgery, chemotherapy and radiotherapy, hormonal manipulation will play an integral role in colon cancer management in the very near future.

  18. Gastrointestinal bleeding under dabigatran

    Directory of Open Access Journals (Sweden)

    C Stöllberger

    2014-01-01

    Full Text Available Dabigatran-absorption is dependent on the intestinal P-glycoprotein (P-gp-system, and P-gp activity is modulated by several drugs. We report an 83-old female with atrial fibrillation who developed gastrointestinal bleeding. She was under a therapy with non-steroidal anti-inflammatory drugs (NSAID and P-gp-modulating drugs and renal function was impaired. We conclude that NSAID and P-gp-modulating drugs should be avoided in dabigatran-treated patients. If renal function deteriorates the dabigatran-dosage should be reduced or the therapy should be stopped. There is an urgent need to increase knowledge about drug interactions with dabigatran.

  19. Obesity and Gastrointestinal Diseases

    Directory of Open Access Journals (Sweden)

    Ai Fujimoto

    2013-01-01

    Full Text Available The prevalence of obesity in the Japanese population has been increasing dramatically in step with the Westernization of lifestyles and food ways. Our study demonstrated significant associations between obesity and a number of gastrointestinal disorders in a large sample population in Japan. We demonstrated that reflux esophagitis and hiatal hernia were strongly related to obesity (BMI > 25 in the Japanese. In particular, obesity with young male was a high risk for these diseases. On the other hand, it has been reported that obesity is also associated with Barrett’s esophagus and colorectal adenoma; however, obesity was not a risk factor for these diseases in our study. The difference of ethnicity of our subjects may partly explain why we found no data to implicate obesity as a risk factor for Barrett’s esophagus. Arterial sclerosis associated with advanced age and hyperglycemia was accompanied by an increased risk of colorectal adenoma.

  20. [Obesity and gastrointestinal motility].

    Science.gov (United States)

    Lee, Joon Seong

    2006-08-01

    Gastrointestinal (GI) motility has a crucial role in the food consumption, digestion and absorption, and also controls the appetite and satiety. In obese patients, various alterations of GI motility have been investigated. The prevalence of GERD and esophageal motor disorders in obese patients are higher than those of general population. Gastric emptying of solid food is generally accelerated and fasting gastric volume especially in distal stomach is larger in obese patients without change in accommodation. Contractile activity of small intestine in fasting period is more prominent, but orocecal transit is delayed. Autonomic dysfunction is frequently demonstrated in obese patients. These findings correspond with increased appetite and delayed satiety in obese patients, but causes or results have not been confirmed. Therapeutic interventions of these altered GI motility have been developed using botulinum toxin, gastric electrical stimulation in obese patients. Novel agents targeted for GI hormone modulation (such as ghrelin and leptin) need to be developed in the near future. PMID:16929152

  1. [Neurologic and psychiatric manifestations of Lyme disease].

    Science.gov (United States)

    Blanc, F

    2007-01-01

    The neurological and psychiatric manifestations of Borrelia burgdorferi sensu lato are so numerous that Borrelia is also called the "new great imitator". Thus knowing about the multiple clinical aspects of neuroborreliosis is necessary for the clinician. We reviewed literature for "classical" neuroborreliosis such as acute meningoradiculitis or chronicle encephalomyelitis, but also for encephalitis, myelitis, polyneuritis, radiculitis and more controversial disorders such as chronic neurological disorders, ischemic and hemorrhagic stroke, and motor neuron disease. We specified every time on which basis each disorder was attributed to Lyme disease, particularly if European or American criteria were met. Every part of the nervous system can be involved: from central to peripheral nervous system, and even muscles. In endemic areas, Lyme serology must be assessed in case of unexplained neurological or psychiatric disorder. In case of positive serology, CSF assessment with intrathecal anti-Borrelia antibody index will be more efficient to prove the diagnosis. PMID:17350199

  2. Atypical Radiological Manifestation of Pulmonary Metastatic Calcification

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Hae; Kim, Eun Sun; Kim, Chul Hwan; Ham, Soo Youn; Oh, Yu Whan [Korea University College of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    Metastatic pulmonary calcification is a condition of calcium deposition in the normal pulmonary parenchyma, and this is secondary to abnormal calcium metabolism without any prior soft tissue damage. The predisposing factors for this condition include chronic renal failure, hypercalcemia and increased tissue alkalinity. The most common radiologic manifestation consists of poorly defined nodular opacities in the upper lung zone. These opacities reflect the deposition of calcium salts in the pulmonary interstitium. We present here a case of metastatic pulmonary calcification in a patient who recovered from pneumonia with sepsis and whose high-resolution CT (HRCT) images demonstrated localized parenchymal airspace calcification that was limited to the bilateral lower lobes. These lower lobes had been involved with pneumonic consolidation without calcification, as seen on the previous CT scan. In summary, we report here on an atypical presentation of metastatic pulmonary calcification that showed dense airspace consolidation localized to the bilateral lower lobes in a patient with primary hyperparathyroidism and pneumonia.

  3. Manifestations of juvenile polyposis syndrome in SMAD4 mutation carriers of a kindred.

    Science.gov (United States)

    Schwetz, Verena; Uhrig, Sabine; Spuller, Ekkehard; Deutschmann, Andrea; Högenauer, Christoph

    2012-08-01

    The autosomal dominantly inherited juvenile polyposis syndrome (JPS) leads to the development of multiple hamartomatous polyps in the gastrointestinal tract and is a precancerous condition. In a large family with a newly identified SMAD4 mutation (c.543delC), we describe the clinical manifestations of JPS. Nine affected SMAD4 mutation-positive family members were screened and treated for manifestations of JPS. Two family members were symptomatic at the time of diagnosis; seven were asymptomatic - independent of the severity of the manifestation. Each mutation carrier presented with colonic juvenile polyps, seven out of nine with additional gastric manifestations. One asymptomatic patient had early gastric cancer; another patient had a villous adenoma with high-grade intraepithelial neoplasia in the colon. Three patients had biliary lesions including a bile duct hamartoma in one and gallbladder polyps in two. Three patients had gastrointestinal vascular malformations. All mutation carriers were affected by JPS. Interestingly, the manifestations and their severity differed considerably between the patients, suggesting secondary factors influencing JPS manifestations such as Helicobacter pylori infection. PMID:22617360

  4. Neurological manifestations of Batch s disease

    International Nuclear Information System (INIS)

    To determine the prevalence, clinical manifestations, and laboratory features of Neuro-Behcets disease. This prospective study was carried out in the Behcets Research Clinic in Shiraz (south-west Iran) and included the patients referred from 1990-1999. The patients' clinical records, images, CSF analyses, and electrodiagnostic studies were reviewed. Eighteen (15 males and 3 females) out of 690 Behcet s patients (2.6%, 95% CI = 1.4-3.8%) were found to have neurological involvement. The mean +/- standard deviation age of these patients was 34.7 +/- 8.6 years. All fulfilled the criteria of the International Study Group of Behcet s Disease. Central nervous system involvement was more common than peripheral nervous system manifestations. Headache, weakness, tingling, and numbness were the most common symptoms. Hyperreflexia, upward plantar reflex, and somatosensory findings were the most frequent signs. Hemispheral and brainstem stroke-like syndromes and cerebral venous thrombosis were the major neurologic presentations. There were also cases of myelitic, pure meningoencephalitic, amyotrophic lateral sclerosis-like, multiple sclerosis-like, and Guillain Barre syndromes. Neuro-Behcets disease must be considered in the differential diagnosis of stroke in young adults, chronic meningitis, intracranial hypertension, multiple sclerosis, myelopathies, and peripheral neuropathies. (author)

  5. Gastrointestinal diseases of Napoleon in Saint Helena: causes of death.

    Science.gov (United States)

    Di Costanzo, Jacques

    2002-01-01

    The fact that Napoleon Ist died from gastric cancer seems to be well established. Arguments for the hypothesis of chronic arsenic poisoning have recently been developed in the literature. This study, focused on the gastrointestinal diseases of Napoleon in Saint Helena, is based on a confrontation between the clinical semiological anamnesis and the anatomical data in the autopsy report by F. Antommarchi. Napoleon presented several gastrointestinal diseases: gall-bladder lithiasis complicated with angiocholitis, chronic colitis and certainly a gastric cancer. Death was consecutive to perforation of the gastric lesion leading to haemorrhagic vomitis and multiorgan failure. The description of the gastric lesions during autopsy is consistent with the diagnosis of cancer. The course of the clinical events is closely correlated with the anatomic lesions. There is strong evidence that Napoleon died from an acute complication of his gastric disease.

  6. From the radiologic pathology archives: gastrointestinal lymphoma: radiologic and pathologic findings.

    Science.gov (United States)

    Lewis, Rachel B; Mehrotra, Anupamjit K; Rodríguez, Pablo; Manning, Maria A; Levine, Marc S

    2014-01-01

    Gastrointestinal (GI) lymphoma encompasses a heterogeneous group of neoplasms that have a common lymphoid origin but variable pathologic and imaging features. Extranodal marginal zone B-cell lymphoma (ENMZL) and diffuse large B-cell lymphoma (DLBCL) are the most common. ENMZL usually occurs in the stomach, where it is associated with chronic infection by Helicobacter pylori, and is typically a superficial spreading lesion that causes mucosal nodularity or ulceration and mild wall thickening. DLBCL may arise de novo or from transformation of ENMZL or other low-grade lymphomas. This form of lymphoma produces extensive wall thickening or a bulky mass, but obstruction is uncommon. Mantle cell lymphoma is the classic cause of lymphomatous polyposis, but multiple polyps or nodules can also be seen with ENMZL and follicular lymphoma. Burkitt lymphoma is usually characterized by an ileocecal mass or wall thickening in the terminal ileum in young children, often in the setting of widespread disease. Primary GI Hodgkin lymphoma, which is rare, may be manifested by a variety of findings, though stenosis is more common than with non-Hodgkin lymphoma. Enteropathy-associated T-cell lymphoma is frequently associated with celiac disease and is characterized by wall thickening, ulceration, and even perforation of the jejunum. Accurate radiologic diagnosis of GI lymphoma requires a multifactorial approach based on the clinical findings, site of involvement, imaging findings, and associated complications. PMID:25384294

  7. Successful therapy for protein-losing enteropathy caused by chronic neuronopathic Gaucher disease.

    Science.gov (United States)

    Mhanni, A A; Kozenko, M; Hartley, J N; Deneau, M; El-Matary, W; Rockman-Greenberg, C

    2016-03-01

    Gaucher disease (OMIM #230800) is caused by β-glucosidase deficiency and primarily involves the mononuclear phagocyte system (also called Reticuloendothelial System or Macrophage System). The disease is classified into three main phenotypes based on the presence or absence of neurological manifestations: non-neuronopathic (type 1), acute neuronopathic (type 2) and chronic neuronopathic (type 3). Typical manifestations include hepatosplenomegaly, skeletal deformities, hematological abnormalities, interstitial lung fibrosis and neurodegeneration in neuronopathic cases. Mesenteric lymphadenopathy with resultant protein losing enteropathy (PLE) has only been rarely described. Mesenteric lymphadenopathy may lead to intestinal lymphatic obstruction and secondary lymphangiectasia resulting in chronic diarrhea, abdominal pain and weight loss. Fecal protein loss with secondary hypoalbuminemia can be significant. We report a male with Chronic Neuronopathic Gaucher disease (GD) (homozygous for c.1448T > C (NM_000157.3) GBA mutation) who at 16 years of age developed intractable abdominal pain, diarrhea and weight loss. This was caused by PLE secondary to intestinal lymphangiectasia caused by calcified mesenteric lymphadenopathy despite prior long term enzyme replacement therapy (ERT) and/or substrate reduction therapy (SRT). His older similarly affected sister who had been receiving treatment with ERT and/or SRT remains stable on these treatments with no evidence of mesenteric lymphadenopathy. Medical management with total parenteral nutrition, daily medium chain triglyceride-oil (MCT) supplementation, low dose oral budesonide, continued oral SRT and an increased dose of parenteral ERT has stabilized his condition with resolution of the gastrointestinal symptoms and appropriate weight gain. PMID:27014572

  8. Successful therapy for protein-losing enteropathy caused by chronic neuronopathic Gaucher disease

    Directory of Open Access Journals (Sweden)

    A.A. Mhanni

    2016-03-01

    Full Text Available Gaucher disease (OMIM #230800 is caused by β-glucosidase deficiency and primarily involves the mononuclear phagocyte system (also called Reticuloendothelial System or Macrophage System. The disease is classified into three main phenotypes based on the presence or absence of neurological manifestations: non-neuronopathic (type 1, acute neuronopathic (type 2 and chronic neuronopathic (type 3. Typical manifestations include hepatosplenomegaly, skeletal deformities, hematological abnormalities, interstitial lung fibrosis and neurodegeneration in neuronopathic cases. Mesenteric lymphadenopathy with resultant protein losing enteropathy (PLE has only been rarely described. Mesenteric lymphadenopathy may lead to intestinal lymphatic obstruction and secondary lymphangiectasia resulting in chronic diarrhea, abdominal pain and weight loss. Fecal protein loss with secondary hypoalbuminemia can be significant. We report a male with Chronic Neuronopathic Gaucher disease (GD (homozygous for c.1448T>C (NM_000157.3 GBA mutation who at 16 years of age developed intractable abdominal pain, diarrhea and weight loss. This was caused by PLE secondary to intestinal lymphangiectasia caused by calcified mesenteric lymphadenopathy despite prior long term enzyme replacement therapy (ERT and/or substrate reduction therapy (SRT. His older similarly affected sister who had been receiving treatment with ERT and/or SRT remains stable on these treatments with no evidence of mesenteric lymphadenopathy. Medical management with total parenteral nutrition, daily medium chain triglyceride-oil (MCT supplementation, low dose oral budesonide, continued oral SRT and an increased dose of parenteral ERT has stabilized his condition with resolution of the gastrointestinal symptoms and appropriate weight gain.

  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. Anisakidosis: a fortuitous mimicker of gastrointestinal malignancy.

    Science.gov (United States)

    Khan, Mohammad Qasim; Williams, Jonathan

    2016-01-01

    A 51-year-old woman presented with epigastric pain, vomiting and diarrhoea. Her sister was recently diagnosed with duodenal adenocarcinoma, manifesting similar symptoms. Imaging revealed thickened gastric antrum with enlarged local lymph nodes. Endoscopy illustrated 3 worms embedded in the antral wall, identified as Anisakis simplex larvae. Larvae removal and a 2-week albendazole regimen treated the symptoms. With globalisation of cultural culinary practices, physicians must be vigilant of anisakidosis. Its ability to mimic peptic ulcer disease, chronic gastritis and malignancy necessitates broader differential diagnoses and lower thresholds for endoscopy. PMID:27600057

  11. Anisakidosis: a fortuitous mimicker of gastrointestinal malignancy.

    Science.gov (United States)

    Khan, Mohammad Qasim; Williams, Jonathan

    2016-01-01

    A 51-year-old woman presented with epigastric pain, vomiting and diarrhoea. Her sister was recently diagnosed with duodenal adenocarcinoma, manifesting similar symptoms. Imaging revealed thickened gastric antrum with enlarged local lymph nodes. Endoscopy illustrated 3 worms embedded in the antral wall, identified as Anisakis simplex larvae. Larvae removal and a 2-week albendazole regimen treated the symptoms. With globalisation of cultural culinary practices, physicians must be vigilant of anisakidosis. Its ability to mimic peptic ulcer disease, chronic gastritis and malignancy necessitates broader differential diagnoses and lower thresholds for endoscopy.

  12. Acute syndrome of radiation: injuries to the gastrointestinal tract

    International Nuclear Information System (INIS)

    Acute syndrome of radiation: injuries to the gastrointestinal tract. Exposure to ionising radiation at medium to high doses results in the manifestation of mixed pathologies. Following the analysis of several radiation accidents it is clear that intestinal injury influences patient survival. However the appearance of the classically defined gastrointestinal syndrome is not always evident. Nevertheless injury to the gastrointestinal tract, in particular loss of barrier function, seems to play an important role in the development of Multiple Organ Failure such as reported in the recent accident at Tokai Mura. Ionising radiation overexposure results in changes in intestinal motility and nutrient, fluid and electrolyte absorption and secretion all which may contribute to the genesis of diarrhea. In addition to modified cellular transport properties for nutrients or electrolytes, important loss of epithelial cells is also a major contributing factor. Intestinal functions are controlled by many factors such as neurotransmitters, locally released mediators from endocrine cells or immunocompetent cells in addition to luminal agents. To date, treatment of radiation-induced gastrointestinal injury is mainly symptomatic. However treatments such as growth factors, anti-inflammatory cytokines as well as cellular transplantation remain to be validated in the radiation accident situation. (author)

  13. Chronic Chagas disease: from basics to laboratory medicine.

    Science.gov (United States)

    Haberland, Annekathrin; Saravia, Silvia Gilka Munoz; Wallukat, Gerd; Ziebig, Reinhard; Schimke, Ingolf

    2013-02-01

    Chagas disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America and has huge potential to become a worldwide problem, due to increasing migration, and international tourism, as well as infectant transfer by blood contact and transfusion, intrauterine transfer, and organ transplantation. Nearly 30% of chronically-infected patients become symptomatic, often with a latency of 10-30 years, developing life-threatening complications. Of those, nearly 90% develop Chagas heart disease, while the others manifest gastrointestinal disease and neuronal disorders. Besides interrupting the infection cycle and chemo therapeutic infectant elimination, starting therapy early in symptomatic patients is important for counteracting the disease. This would be essentially supported by optimized patient management, involving risk assessment, early diagnosis and monitoring of the disease and its treatment. From economic and logistic viewpoints, the tools of laboratory medicine should be especially able to guarantee this. After summarizing the basics of chronic Chagas disease, such as the epidemiological data, the pathogenetic mechanisms thought to drive symptomatic Chagas disease and also treatment options, we present tools of laboratory medicine that address patient diagnosis, risk assessment for becoming symptomatic and guidance, focusing on autoantibody estimation for risk assessment and heart marker measurement for patient guidance. In addition, increases in levels of inflammation and oxidative stress markers in chronic Chagas disease are discussed.

  14. Optimising the management of gastrointestinal symptoms following pelvic radiotherapy.

    OpenAIRE

    Henson, Caroline Claire

    2014-01-01

    BackgroundPelvic radiotherapy is a well-established treatment for pelvic malignancies, with 30,000 patients per year in the UK receiving radical pelvic radiotherapy either alone or in combination with other oncological treatments. 80% develop acute gastrointestinal (GI) symptoms and 50% develop chronic GI symptoms and in parallel to improvements in survival, increasing numbers of patients are living to develop the long term consequences of treatment. Despite this, less than 20% of patients wh...

  15. Treatment of iron deficiency anemia associated with gastrointestinal tract diseases

    Institute of Scientific and Technical Information of China (English)

    Ulas; D; Bayraktar; Soley; Bayraktar

    2010-01-01

    The gastrointestinal (GI) tract is a common site of bleeding that may lead to iron deficiency anemia (IDA). Treatment of IDA depends on severity and acuity of patients’ signs and symptoms. While red blood cell transfusions may be required in hemodynamically unstable patients, transfusions should be avoided in chronically anemic patients due to their potential side effects and cost. Iron studies need to be performed after episodes of GI bleeding and stores need to be replenished before anemia develops. Oral ...

  16. An Unusual Cause of Gastrointestinal Bleeding: Duodenal Lipoma

    Directory of Open Access Journals (Sweden)

    R. Kadaba

    2011-04-01

    Full Text Available Common causes of chronic upper gastrointestinal bleeding include oesophageal varices, gastroduodenal ulcers and malignancy, and patients mostly present with iron deficiency type anaemia. We present the case of a 60-year-old lady who presented with iron deficiency anaemia and on investigation was found to have a large duodenal polyp requiring surgical excision. On histological examination, the polyp was revealed to be a lipoma. We review the recent literature and formulate a management plan for this rare entity.

  17. Cutaneous manifestations in celiac disease

    Institute of Scientific and Technical Information of China (English)

    L Abenavoli; G Addolorato; I Proietti; L Leggio; A Ferrulli; L Vonghia; R Capizzi; M Rotoli; PL Amerio; G Gasbarrini

    2006-01-01

    Celiac disease (CD) is an autoimmune gluten-dependent enteropathy characterized by atrophy of intestinal villi that improves after gluten-free diet (GFD). CD is often associated with extra-intestinal manifestations;among them, several skin diseases are described in CD patients. The present review reports all CD-associated skin manifestations described in the literature and tries to analyze the possible mechanisms involved in this association. The opportunity to evaluate the possible presence of CD in patients affected by skin disorders is discussed.

  18. Gastrointestinal symptoms in patients undergoing peritoneal dialysis: Multivariate analysis of correlated factors

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To investigate gastrointestinal (GI) symptoms in peritoneal dialysis (PD) patients and to explore related factors contributing to GI symptoms. METHODS: One hundred and twelve patients undergoing PD participated in the study. The gastrointestinal symptom rating scale was used for measuring GI symptoms. Information on age, height, weight, body mass index, disease leading to chronic renal failure, history of corticosteroid therapy, presence of predialytic GI symptoms, daily dosage of pills, and duration, ...

  19. Antioxidant supplements for preventing gastrointestinal cancers

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Nikolova, Dimitrinka; Simonetti, Rosa G;

    2008-01-01

    Oxidative stress may cause gastrointestinal cancers. The evidence on whether antioxidant supplements are effective in preventing gastrointestinal cancers is contradictory.......Oxidative stress may cause gastrointestinal cancers. The evidence on whether antioxidant supplements are effective in preventing gastrointestinal cancers is contradictory....

  20. Epigenetic mechanisms and gastrointestinal development

    Science.gov (United States)

    This review considers the hypothesis that nutrition during infancy affects developmental epigenetics in the gut, causing metabolic imprinting of gastrointestinal (GI) structure and function. Fundamentals of epigenetic gene regulation are reviewed, with an emphasis on the epigenetic mechanism of DNA ...

  1. Sleep Dysfunction and Gastrointestinal Diseases.

    Science.gov (United States)

    Khanijow, Vikesh; Prakash, Pia; Emsellem, Helene A; Borum, Marie L; Doman, David B

    2015-12-01

    Sleep deprivation and impaired sleep quality have been associated with poor health outcomes. Many patients experience sleep disturbances, which can increase the risk of medical conditions such as hypertension, obesity, stroke, and heart disease as well as increase overall mortality. Recent studies have suggested that there is a strong association between sleep disturbances and gastrointestinal diseases. Proinflammatory cytokines, such as tumor necrosis factor, interleukin-1, and interleukin-6, have been associated with sleep dysfunction. Alterations in these cytokines have been seen in certain gastrointestinal diseases, such as gastroesophageal reflux disease, inflammatory bowel disease, liver disorders, and colorectal cancer. It is important for gastroenterologists to be aware of the relationship between sleep disorders and gastrointestinal illnesses to ensure good care for patients. This article reviews the current research on the interplay between sleep disorders, immune function, and gastrointestinal diseases. PMID:27134599

  2. Primary pediatric gastrointestinal lymphoma

    Directory of Open Access Journals (Sweden)

    Ranjana Bandyopadhyay

    2011-01-01

    Full Text Available Background: Primary non-Hodgkin′s lymphoma (NHL of the gastrointestinal (GI tract is the most common extranodal lymphoma in pediatric age group. Yet, the overall incidence is very low. The rarity of the disease as well as variable clinical presentation prevents early detection when the possibility of cure exists. Materials and Methods: We studied six cases of primary GI NHL in pediatric age group with reference to their clinical presentation, anatomic distribution and histopathologic characteristics. Results: All were males except one. Intestinal obstruction was the presenting feature in 50%. Half the cases showed ileocaecal involvement, while large bowel was involved in 16%. Histology showed four cases of diffuse large B-cell lymphoma (DLBCL, one case of Burkitt lymphoma, and one Burkitt-like lymphoma. Immunohistochemistry for Tdt, CD20, CD3, CD30, bcl2, bcl6 confirmed the morphological diagnosis. Conclusion: Pediatric GI lymphoma commonly involves the ileocaecal region and presents with intestinal obstruction. A higher prevalence of DLBCL is found compared to other series. A high proliferative index is useful in differentiating Burkitt-like lymphoma from DLBCL.

  3. Feline gastrointestinal microbiota.

    Science.gov (United States)

    Minamoto, Yasushi; Hooda, Seema; Swanson, Kelly S; Suchodolski, Jan S

    2012-06-01

    The close relationship between gastrointestinal (GI) microbiota and its host has an impact on the health status of an animal that reaches beyond the GI tract. A balanced microbiome stimulates the immune system, aids in the competitive exclusion of transient pathogens and provides nutritional benefits to the host. With recent rapid advances in high-throughput sequencing technology, molecular approaches have become the routinely used tools for ecological studies of the feline microbiome, and have revealed a highly diverse and complex intestinal ecosystem in the feline GI tract. The major bacterial groups are similar to those found in other mammals, with Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria constituting more than 99% of intestinal microbiota. Several nutritional studies have demonstrated that the feline microbiota can be modulated by the amount of soluble fibers (i.e., prebiotics) and macronutrients (i.e., protein content) in the diet. Initial clinical studies have suggested the presence of a dysbiosis in feline inflammatory bowel disease (IBD). Recently, metagenomic approaches have attempted to characterize the microbial gene pool. However, more studies are needed to describe the phylogenetic and functional changes in the intestinal microbiome in disease states and in response to environmental and dietary modulations. This paper reviews recent studies cataloging the microbial phylotypes in the GI tract of cats.

  4. Epidemiology of gastrointestinal cancer.

    Science.gov (United States)

    Selikoff, I J

    1974-12-01

    Some 99,000 new cases of cancer of the colon are expected next year, an incidence rate higher than that for both cancer of the lung and cancer of the breast. Evidence from geographic pathology suggests that some environmental factors play a strong role in its etiology. Data obtained in the 1959 survey of one million people by the American Cancer Society and followed since, has failed to show correlation with any of the large number of factors listed. It is suggested that the etiology is one of multiple factors. The synergistic effect of exposure to asbestos and cigarette smoking in the production of bronchogenic carcinoma is demonstrated by data on cohorts of insulation workers. There was also a modest increase in the number of deaths from gastrointestinal cancer in asbestos workers, but smoking did not seem to act in synergistic fashion at that site, except perhaps in the esophagus. Deaths from cancer occurred almost entirely after a period of 20 years or more from initial exposure. The death rate from cancer tended to increase with duration of exposure, but a distinct rise over the expected was seen in those who had been exposed less than one year to amosite dust. PMID:4470947

  5. [Acute gastrointestinal bleeding].

    Science.gov (United States)

    Baumbach, Robert; Faiss, Siegbert; Cordruwisch, Wolfgang; Schrader, Carsten

    2016-04-01

    Acute gastrointestinal bleeding is a common major emergency (Internal medical or gastroenterological or medical), approximately 85 % of which occur in the upper GI tract. It is estimated that about a half of upper GI bleeds are caused by peptic ulcers. Upper GI bleeds are associated with more severe bleeding and poorer outcomes when compared to middle or lower GI bleeds. Prognostic determinants include bleeding intensity, patient age, comorbid conditions and the concomitant use of anticoagulants. A focused medical history can offer insight into the bleeding intensity, location and potential cause (along with early risk stratification). Initial measures should focus on rapid assessment and resuscitation of unstable patients. The oesophagogastroduodenoscopy (OGD) is the gold standard method for localizing the source of bleeding and for interventional therapy. Bleeding as a result of peptic ulcers is treated endoscopically with mechanical and / or thermal techniques in combination with proton pump inhibitor (PPI) therapy. When variceal bleeding is suspected, pre-interventional use of vasopressin analogues and antibiotic therapies are recommended. Endoscopically, the first line treatment of esophageal varices is endoscopic ligature therapy, whereas that for gastric varices is the use of Histoacryl injection sclerotherapy. When persistent and continued massive hemorrhage occurs in a patient with known or suspected aortic disease the possibility of an aorto-enteric fistula must be considered. PMID:27078246

  6. Oral manifestations of hepatitis C virus infection

    Science.gov (United States)

    Carrozzo, Marco; Scally, Kara

    2014-01-01

    Extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection can affect a variety of organ systems with significant morbidity and mortality. Some of the most frequently reported EHM of HCV infection, involve the oral region predominantly or exclusively. Oral lichen planus (OLP) is a chronic inflammatory condition that is potentially malignant and represents cell-mediated reaction to a variety of extrinsic antigens, altered self-antigens, or super antigens. Robust epidemiological evidence support the link between OLP and HCV. As the virus may replicate in the oral mucosa and attract HCV-specific T lymphocytes, HCV may be implicated in OLP pathogenesis. Sjögren syndrome (SjS) is an autoimmune exocrinopathy, characterized by dryness of the mouth and eyes and a multitude of other systemic signs and symptoms. SjS patients have also an increased risk of non-Hodgkin lymphoma. Patients with chronic hepatitis C do frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, it is still unclear if HCV may cause a disease mimicking SjS or it is directly responsible for the development of SjS in a specific subset of patients. Oral squamous cell carcinoma is the most common oral malignant tumour and at least in some part of the world could be linked to HCV. PMID:24976694

  7. Oral manifestations of hepatitis C virus infection.

    Science.gov (United States)

    Carrozzo, Marco; Scally, Kara

    2014-06-28

    Extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection can affect a variety of organ systems with significant morbidity and mortality. Some of the most frequently reported EHM of HCV infection, involve the oral region predominantly or exclusively. Oral lichen planus (OLP) is a chronic inflammatory condition that is potentially malignant and represents cell-mediated reaction to a variety of extrinsic antigens, altered self-antigens, or super antigens. Robust epidemiological evidence support the link between OLP and HCV. As the virus may replicate in the oral mucosa and attract HCV-specific T lymphocytes, HCV may be implicated in OLP pathogenesis. Sjögren syndrome (SjS) is an autoimmune exocrinopathy, characterized by dryness of the mouth and eyes and a multitude of other systemic signs and symptoms. SjS patients have also an increased risk of non-Hodgkin lymphoma. Patients with chronic hepatitis C do frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, it is still unclear if HCV may cause a disease mimicking SjS or it is directly responsible for the development of SjS in a specific subset of patients. Oral squamous cell carcinoma is the most common oral malignant tumour and at least in some part of the world could be linked to HCV. PMID:24976694

  8. Heme oxygenase-1 system and gastrointestinal inflammation:A short review

    Institute of Scientific and Technical Information of China (English)

    Xiao Zhu; Wen-Guo Fan; Dong-Pei Li; Hsiangfu Kung; Marie CM Lin

    2011-01-01

    Heme oxygenase-1 (HO-1) system catalyzes heme to biologically active products:carbon monoxide,bili-verdin/bilirubin and free iron.It is involved in maintaining cellular homeostasis and many physiological and pathophysiological processes.A growing body of evidence indicates that HO-1 activation may play an important protective role in acute and chronic inflammation of gastrointestinal tract.This review focuses on the current understanding of the physiological significance of HO-1 induction and its possible roles inthe gastrointestinal inflammation studied to date.The ability to upregulate HO-1 by pharmacological means or using gene therapy may offer therapeutic strategies for gastrointestinal inflammation in the future.

  9. Gastrointestinal function development and microbiota

    OpenAIRE

    Di Mauro, Antonio; Neu, Josef; Riezzo, Giuseppe; Raimondi, Francesco; Martinelli, Domenico; Francavilla, Ruggiero; Indrio, Flavia

    2013-01-01

    The intestinal microbiota plays an important role in the development of post-natal gastrointestinal functions of the host. Recent advances in our capability to identify microbes and their function offer exciting opportunities to evaluate the complex cross talk between microbiota, intestinal barrier, immune system and the gut-brain axis. This review summarizes these interactions in the early colonization of gastrointestinal tract with a major focus on the role of intestinal microbiota in the p...

  10. Erythema elevatum diutinum på glans penis er en sjælden manifestation

    DEFF Research Database (Denmark)

    Harbjerg, Julie Lykke; Krarup, Kim Predbjørn

    2014-01-01

    Erythema elevatum diutinum (EED) is a rare chronic cutaneous vasculitis, which typically manifests as symmetrical, chronic plaques or nodules on the extensor sides of the extremities, on truncus or nates. We present a case where EED-compatible plaques were located on glans penis. To our knowledge...

  11. Foreign bodies in gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Ayşe Kefeli

    2014-03-01

    Full Text Available Objective: Ingested foreign bodies in gastrointestinal tract are a common event which can cause serious morbidity and mortality in the children and adult population. For this reason, early diagnosis and treatment are crucial for preventing these life threatening complications. In this study, we aimed to analyze the characteristics of the patients with upper gastrointestinal foreign bodies that were treated in our department. Methods: Patients diagnosed with upper gastrointestinal foreign bodies who were admitted to our hospital between February 2010 and August2013 were evaluated retrospectively. The data regarding their age, gender, clinical profile, type and localization of the esophageal foreign body, performed endoscopic procedure and initial symptoms of the patients were noted and analyzed statistically. Results: Thirty-eight patients with a diagnosis of gastrointestinal foreign body were included in this study. Of these patients, 21 were male and 17 were female. The youngest patient was 17 years old and the oldest patient was 79 years old. Most of the foreign bodies (%55.3 detected in the stomach. Food waste and metallic objects in 21 and 16 patients respectively. The most common complaint was dysphagia (%50. After endoscopic intervention three of the patients were directed to surgery. Conclusion: Early recognition and treatment of gastrointestinal foreign bodies is important as their complications are life threatening. The best method of removal of foreign bodies is controversial. Early management with upper gastrointestinal endoscopy is the most efficient and safe treatment method in current conditions.

  12. Pancreatic panniculitis: a cutaneous manifestation of acute pancreatitis

    OpenAIRE

    Laureano, A; Mestre, T; Ricardo, L; Rodrigues, AM; Cardoso, J.

    2014-01-01

    Pancreatic panniculitis is a rare disease in which necrosis of fat in the panniculus and other distant foci occurs in the setting of pancreatic diseases; these diseases include acute and chronic pancreatitis, pancreatic carcinoma, pseudocyst, and other pancreatic diseases. This malady is manifested as tender erythematous nodules on the legs, buttock, or trunk. Histopathologically, it shows the pathognomonic findings of focal subcutaneous fat necrosis and ghost-like anucleated cells with a thi...

  13. Diagnosis and management of chronic pancreatitis

    OpenAIRE

    Gupta, V.; TOSKES, P.

    2005-01-01

    Chronic pancreatitis represents a condition that is challenging for clinicians secondary to the difficulty in making an accurate diagnosis and the less than satisfactory means of managing chronic pain. This review emphasises the various manifestations that patients with chronic pancreatitis may have and describes recent advances in medical and surgical therapy. It is probable that many patients with chronic abdominal pain are suffering from chronic pancreatitis that is not appreciated. As the...

  14. 具有间质性肺病及慢性阻塞性肺病肺背景的周围型肺癌毛刺征的CT表现%CT manifestations of spicular sign in peripheral lung cancer under background complicated by interstitial lung disease and chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    侯书法; 马大庆

    2012-01-01

    目的 探讨具有间质性肺病及慢性阻塞性肺病(COPD)的肺背景与周围型肺癌(PLC)毛刺征CT表现之间的联系.方法 收集经病理证实的100例PLC,将其分为2组,其中间质性肺病及COPD组67例,无间质性肺病及COPD组33例,比较2组病灶CT毛刺征表现的差异.结果 间质性肺病及COPD组毛刺出现率明显较无间质性肺病及COPD组高,间质性肺病及COPD组为88%(59/67),无间质性肺病及COPD组为70%(23/33),具有明显统计学差异(P<0.05).具有间质性肺病肺背景的PLC的毛刺形态与肺间质疾病的线状影表现一致,周围间质改变越明显,毛刺越多;具有COPD肺背景的PLC毛刺形态多样,为小叶中心肺气肿的壁构成,形态与病灶周围肺气肿严重程度有关.结论 具有间质性肺病及COPD背景的PLC毛刺出现率较高,具有间质性肺病及COPD的肺背景对PLC毛刺征CT表现有影响.%Objective To study the relationship between CT manifestations of spicular sign in peripheral lung cancer (PLC) under background complicated by interstitial lung disease and chronic obstructive pulmonary disease (COPD). Methods 100 cases with PLC confirmed by pathological diagnosis were collected and divided into two groups:PLC complicated by interstitial lung disease andf COPD groupfgroup A,67 cases) ,PLC without the complications of interstitial lung disease and COPD group (group B,33 cases). The differences of CT manifestations of spicular sign between two groups were compared. Results The frequency of spicular sign in group A( 88%, 59/67) was much higher than that in group B( 70%, 23/33) , there was significant difference between two groups (P <0. 05). CT manifestations of spicular sign as linear opacity in PLC complicated by interstitial lung disease were agreement with that in interstitial lung disease. The more alterations were in peripheral intersitium, the more spiculations were in PLC. Spicular appearances of PLC complicated by COPD were multiplicity, which

  15. 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 ...

  16. Surveillance for gastrointestinal malignancies

    Institute of Scientific and Technical Information of China (English)

    Ashish K Tiwari; Heather S Laird-Fick; Ramesh K Wali; Hemant K Roy

    2012-01-01

    Gastrointestinal (GI) malignancies are notorious for frequently progressing to advanced stages even in the absence of serious symptoms,thus leading to delayed diagnoses and dismal prognoses.Secondary prevention of GI malignancies through early detection and treatment of cancer-precursor/premalignant lesions,therefore,is recognized as an effective cancer prevention strategy.In order to efficiently detect these lesions,systemic application of screening tests (surveillance) is needed.However,most of the currently used non-invasive screening tests for GI malignancies (for example,serum markers such as alpha-fetoprotein for hepatocellular carcinoma,and fecal occult blood test,for colon cancer) are only modestly effective necessitating the use of highly invasive endoscopy-based procedures,such as esophagogastroduodenoscopy and colonoscopy for screening purposes.Even for hepatocellular carcinoma where non-invasive imaging (ultrasonography) has become a standard screening tool,the need for repeated liver biopsies of suspicious liver nodules for histopathological confirmation can't be avoided.The invasive nature and high-cost associated with these screening tools hinders implementation of GI cancer screening programs.Moreover,only a small fraction of general population is truly predisposed to developing GI malignancies,and indeed needs surveillance.To spare the average-risk individuals from superfluous invasive procedures and achieve an economically viable model of cancer prevention,it's important to identify cohorts in general population that are at substantially high risk of developing GI malignancies (riskstratification),and select suitable screening tests for surveillance in these cohorts.We herein provide a brief overview of such high-risk cohorts for different GI malignancies,and the screening strategies that have commonly been employed for surveillance purpose in them.

  17. Primary gastrointestinal lymphoma

    Directory of Open Access Journals (Sweden)

    Amir Aledavood

    2012-01-01

    Full Text Available Background: Extranodal lymphoma may arise anywhere outside lymph nodes mostly in the gastrointestinal (GI tract as non-Hodgkin′s disease. We reviewed the clinicopathological features and treatment results of patients with primary GI lymphoma. Materials and Methods : A total number of 30 cases with primary GI lymphoma were included in this study. Patients referred to the Radiation Oncology Department of Omid Hospital (Mashhad, Iran during a 5-year period (2006-11. Clinical, paraclinical, and radiological data was collected from medical records of the patients. Results: Out of the 30 patients with primary GI lymphoma in the study, 12 were female (40% and 18 were male (60% (male to female ratio: 3/2. B symptoms were present in 27 patients (90%. Antidiuretic hormone (LDH levels were elevated in 9 patients (32.1%. The most common primary site was stomach in 14 cases (46.7%. Other common sites included small intestine and colon each in 8 patients (26.7%. All patients had histopathologically proven non-Hodgkin′s lymphoma. The most common histologic subtype was diffuse large B-cell lymphoma (DLBL in 16 patients (53.3%. In addition, 28 patients (93.3% received chemotherapy with cyclophosphamide, vincristine, doxorubicin, prednisolone (CHOP regimen. The median course of chemotherapy was 6 cources. Moreover, 8 patients (26.7% received radiotherapy with cobalt 60. The median follow-up time was 26 months. The overall 5-year survival rate was 53% and the median survival time was 60 months. Conclusion : Primary GI lymphoma is commonly seen in stomach and small intestine and mostly is DLBCL or mucosa-associated lymphoid tissue (MALT lymphoma.

  18. Bone morbidity in chronic myeloproliferative neoplasms

    DEFF Research Database (Denmark)

    Farmer, Sarah; Ocias, Lukas Frans; Vestergaard, Hanne;

    2015-01-01

    Patients with the classical Philadelphia chromosome-negative chronic myeloproliferative neoplasms including essential thrombocythemia, polycythemia vera and primary myelofibrosis often suffer from comorbidities, in particular, cardiovascular diseases and thrombotic events. Apparently, there is also...... neoplasms. Chronic inflammation has been suggested to explain the initiation of clonal development and progression in chronic myeloproliferative neoplasms. Decreased bone mineral density and enhanced fracture risk are well-known manifestations of many chronic systemic inflammatory diseases. As opposed to...... systemic mastocytosis (SM) where pathogenic mechanisms for bone manifestations probably involve effects of mast cell mediators on bone metabolism, the mechanisms responsible for increased fracture risk in other chronic myeloproliferative neoplasms are not known....

  19. Coexistence of granulomatosis with polyangiitis (GPA) and Crohn's disease or multiorgan manifestation of the same disease?

    Science.gov (United States)

    Jóźwiak, Lucyna; Ławnicka, Izabela; Książek, Andrzej

    2016-01-01

    Granulomatosis with polyangiitis (GPA) is a systemic necrotizing vasculitis of unknown aetiology, often related to the antineutrophil cytoplasmic antibody (ANCA). GPA was previously named Wegener's granulomatosis (WG). The disease frequently has multisystemic presentation, targeting mainly the respiratory tract and kidneys, but gastrointestinal involvement is uncommon. Crohn's disease (CD) is an inflammatory bowel disease (IBD) with many extraintestinal manifestations. Clinically, symptoms of WG and CD can mimic each other. In this paper a case of GPA manifested initially by severe multiorgan damage including colitis, regarded to be coexistent CD, is presented. The case illustrates the difficulties in establishing the diagnosis when symptoms of the diseases mimic each other.

  20. 40 CFR 262.21 - Manifest tracking numbers, manifest printing, and obtaining manifests.

    Science.gov (United States)

    2010-07-01

    ... ensure that numbers are tightly controlled and remain unique. In particular, the application must... application must also indicate how the printer will pre-print a unique number on each form (e.g., crash or... (i.e., manufacturer and grade of the manifest paper); (ii) Paper weight of each copy; (iii) Ink...

  1. Chronic venous disease as a clinical manifestation of tibial osteochondroma

    Directory of Open Access Journals (Sweden)

    Marcelo Fernandes Lima

    2013-06-01

    Full Text Available Osteochondromas are the most common type of benign tumor of the skeleton. They most frequently affect the distal extremity of the femur, with the tibia being the second most commonly affected long bone. Vascular complications of these lesions are rare, but pseudoaneurysm formation is the most frequently reported of them. In this case report, we describe a case of compression of the popliteal neurovascular bundle by a tibial osteochondroma in a diabetic patient who had been admitted to hospital to treat an infected lesion on his left foot and complained of edema and paresthesia of the left lower limb.

  2. Skin manifestations of child abuse

    OpenAIRE

    Ermertcan Aylin; Ertan Pelin

    2010-01-01

    Child abuse is a major public health problem all over the world. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse and neglect. The most common manifestations of child abuse are cutaneous and their recognition; and differential diagnosis is of great importance. Clinicians, especially dermatologists, should be alert about the skin lesions of child abuse. In the diagnosis and management of child abuse, a multidisciplinary approach with ethical and legal procedur...

  3. Rheumatic manifestations of diabetes mellitus.

    Science.gov (United States)

    Lebiedz-Odrobina, Dorota; Kay, Jonathan

    2010-11-01

    DM is associated with various musculoskeletal manifestations. The strength of this relationship varies among the various musculoskeletal disorders; the associations are based mostly on epidemiologic data. For most of these conditions, definitive pathophysiologic correlates are lacking.Hand and shoulder disorders occur more frequently than other musculoskeletal manifestations of DM. Recognition of the association between DM and shoulder adhesive capsulitis, DD, and stenosing flexor tenosynovitis facilitates their correct diagnosis in the setting of DM and prompt initiation of appropriate treatment, which may include optimizing glycemic control. Conversely, awareness and identification of the characteristic musculoskeletal manifestations of DM may facilitate earlier diagnosis of DM and initiation of glucose-lowering therapy to retard the development of diabetic complications.Much less has been published about the musculoskeletal complications of DM than about its micro- and macrovascular complications. Prospective case-control cohort studies are needed to establish the true prevalence of musculoskeletal complications of DM and the metabolic syndrome, especially in this era of tighter glycemic control.The potential relationship between DM and the development of OA needs to be clarified in large, prospective, case-control cohort studies. The effect on musculoskeletal manifestations of various therapeutic regimens to manage DM should be studied prospectively. Treatment regimens for some musculoskeletal conditions associated with DM, such as DISH, should be studied in larger prospective, randomized,controlled clinical trials.At the molecular level, further studies are warranted to clarify the potential contribution of AGEs and adipokines to the development of OA and diabetic musculoskeletal syndromes, such as shoulder adhesive capsulitis, DD, stenosing flexor tenosynovitis, and LJM. Identification of such molecular targets for therapy would promote the development of

  4. Peritoneal manifestations of parasitic infection.

    Science.gov (United States)

    Kim, So Yeon; Ha, Hyun Kwon

    2008-01-01

    The purpose of this study was to describe of peritoneal manifestations of parasitic infection at CT. A broad spectrum of CT findings can be seen in the peritoneal cavity, including a varying degree of omental or mesenteric infiltration, single or multiple peritoneal mass or nodule, and peritoneal thickening or stranding. Recognition of these findings are crucial for establish an early diagnosis and helps avoid unnecessary surgery. PMID:17924162

  5. Parasitic Diseases With Cutaneous Manifestations.

    Science.gov (United States)

    Ash, Mark M; Phillips, Charles M

    2016-01-01

    Parasitic diseases result in a significant global health burden. While often thought to be isolated to returning travelers, parasitic diseases can also be acquired locally in the United States. Therefore, clinicians must be aware of the cutaneous manifestations of parasitic diseases to allow for prompt recognition, effective management, and subsequent mitigation of complications. This commentary also reviews pharmacologic treatment options for several common diseases. PMID:27621348

  6. Imaging Manifestations of Thoracic Tuberculosis.

    Science.gov (United States)

    Restrepo, Carlos Santiago; Katre, Rashmi; Mumbower, Amy

    2016-05-01

    Despite significant improvements in the diagnosis and treatment of tuberculosis achieved during the last 3 decades, tuberculosis still remains one of the deadliest communicable diseases worldwide. Tuberculosis is still present in all regions of the world, with a more significant impact in developing countries. This article reviews the most common imaging manifestations of primary and postprimary tuberculosis, their complications, and the critical role of imaging in the diagnosis and follow-up of affected patients.

  7. Chronic pancreatitis: Maldigestion, intestinal ecology and intestinal inflammation

    Institute of Scientific and Technical Information of China (English)

    Raffaele Pezzilli

    2009-01-01

    Exocrine pancreatic insufficiency caused by chronic pancreatitis results from various factors whichregulate digestion and absorption of nutrients. Pancreatic function has been extensively studied over the last 40 years, even if some aspects of secretion and gastrointestinal adaptation are not completely understood. The main clinical manifestations of exocrine pancreatic insufficiency are fat malabsorption, known as steatorrhea, which consists of fecal excretion of more than 6 g of fat per day, weightloss, abdominal discomfort and abdominal swelling sensation. Fat malabsorption also results in a deficit of fat-soluble vitamins (A, D, E and K) with consequent clinical manifestations. The relationships between pancreatic maldigestion, intestinal ecology and intestinal inflammation have not received particular attention, even if in clinical practice these mechanisms may be responsible for the low efficacy of pancreatic extracts in abolishing steatorrhea in some patients. The best treatments for pancreatic maldigestion should be re-evaluated, taking into account not only the correction of pancreatic insufficiency using pancreatic extracts and the best duodenal pH to permit optimal efficacy of these extracts, but we also need to consider other therapeutic approaches including the decontamination of intestinal lumen, supplementation of bile acids and, probably, the use of probiotics which may attenuate intestinal inflammation

  8. Skin manifestations and immunological parameters in childhood food allergy.

    Science.gov (United States)

    Oehling, A; Fernández, M; Córdoba, H; Sanz, M L

    1997-01-01

    According to Hansen's contact rule, the digestive system should be considered as the main shock organ, yet in food allergy, this is not the case. Very often specific food triggers clinical manifestations not involving the digestive system; that is, reactions are manifested either in the respiratory system, as asthma or rhinitis, or in the skin. In these cases the BALT (broncho-alveolar lymphoid tissue) and GALT (gastrointestinal lymphoid tissue) units play a basic role in the sensitizations. The purpose of this study was to determine the most frequent skin manifestations of food allergy among children, and the most frequently involved foods. We also thought it interesting to evaluate the diagnostic reliability of the different standard immunological parameters utilized by the study team in food allergy. All patients underwent intracutaneous tests with 12 groups of the most frequent food allergens, as well as serum IgE, antigen-specific IgE against foods, and antigen-specific histamine release tests. Antigen-specific IgG4 determination was performed in some cases. The results obtained confirmed previous studies, the most common manifestations being: angioedema (48%), followed by urticaria (31%) and atopic dermatitis (21%). Regarding the frequency of sensitization to different food allergens, in mono- or polisensitization, fish and egg stand out in our environment. Certain food allergens are more frequently responsible for specific skin manifestations. Thus, for fish sensitization, the most frequent skin manifestation is atopic dermatitis (50%); for egg sensitization, angioedema is the most frequent skin manifestation (50%); and for milk, urticaria (50%). Finally, and in agreement with previous works regarding the diagnostic reliability of in vitro techniques, we found that the histamine release test offered the highest percentage of diagnostic reliability. Only for sensitization to milk proteins did antigen-specific IgE demonstrate higher reliability. Once again, we

  9. Toxoplasmosis and its Ocular Manifestations

    Directory of Open Access Journals (Sweden)

    Koev Kr.

    2014-06-01

    Full Text Available The present review provides general information about the parasitic infection of toxoplasmosis and describes the ways of its transmission. It outlines the importance of the consequences of toxoplasmosis infection and the methods of its prevention. The review traces the harmful effects of the disease on human and animal organisms, the causes and stages of development of the disease. The review specifically focuses on the ocular manifestations of toxoplasmosis which can cause ocular lesions, inflammation and scarring. Herein are described the ways toxoplasmosis can damage the eyes causing chorioretinitis, nystagmus, microphthalmia, etc. Furthermore, the review addresses the problem of how congenital and acquired toxoplasmosis affects eyes. The ocular symptoms of toxoplasmosis include weakened or blurred vision, eyeballs pain, ocular sensitivity to light, etc. The harmful effects of toxoplasmosis to pregnant women and immunocompromised patients have been delineated. Some of the disease manifestations include jaundice, rash, asphyxia, etc. The review traces the diagnostic work-up and comments on common tests for toxoplasmosis, such as taking of blood serum samples. The review ends with the treatment of the disease and of its ocular manifestations in particular, for example application of intravitreous injection. The prevention of the infection is extremely important for pregnant women, immunocompromised patients and patients with AIDS.

  10. Uncommon Manifestations of Intervertebral Disk Pathologic Conditions.

    Science.gov (United States)

    Diehn, Felix E; Maus, Timothy P; Morris, Jonathan M; Carr, Carrie M; Kotsenas, Amy L; Luetmer, Patrick H; Lehman, Vance T; Thielen, Kent R; Nassr, Ahmad; Wald, John T

    2016-01-01

    Beyond the familiar disk herniations with typical clinical features, intervertebral disk pathologic conditions can have a wide spectrum of imaging and clinical manifestations. The goal of this review is to illustrate and discuss unusual manifestations of intervertebral disk pathologic conditions that radiologists may encounter, including disk herniations in unusual locations, those with atypical imaging features, and those with uncommon pathophysiologic findings. Examples of atypical disk herniations presented include dorsal epidural, intradural, symptomatic thoracic (including giant calcified), extreme lateral (retroperitoneal), fluorine 18 fluorodeoxyglucose-avid, acute intravertebral (Schmorl node), and massive lumbar disk herniations. Examples of atypical pathophysiologic conditions covered are discal cysts, fibrocartilaginous emboli to the spinal cord, tiny calcified disks or disk-level spiculated osteophytes causing spinal cerebrospinal fluid (CSF) leak and intracranial hypotension, and pediatric acute calcific discitis. This broad gamut of disease includes a variety of sizes of disk pathologic conditions, from the tiny (eg, the minuscule calcified disks causing high-flow CSF leaks) to the extremely large (eg, giant calcified thoracic intradural disk herniations causing myelopathy). A spectrum of clinical acuity is represented, from hyperacute fibrocartilaginous emboli causing spinal cord infarct, to acute Schmorl nodes, to chronic intradural herniations. The entities included are characterized by a range of clinical courses, from the typically devastating cord infarct caused by fibrocartilaginous emboli, to the usually spontaneously resolving pediatric acute calcific discitis. Several conditions have important differential diagnostic considerations, and others have relatively diagnostic imaging findings. The pathophysiologic findings are well understood for some of these entities and poorly defined for others. Radiologists' knowledge of this broad scope of

  11. 78 FR 11877 - Announcement of Requirements Gathering Meetings for the Electronic Manifest (e-Manifest) System

    Science.gov (United States)

    2013-02-20

    ... electronic manifest (``e-Manifest'') system to capture information regarding the shipment of hazardous waste...-Manifest will facilitate the electronic transmittal of manifests throughout the hazardous waste shipping... inefficiencies associated with the use of paper manifest forms (66 FR 28240). Although comments...

  12. Interventional nutrition for gastrointestinal disease.

    Science.gov (United States)

    Hickman, M A

    1998-11-01

    Nutritional intervention plays a key role in the successful management of gastrointestinal disease. This article focuses on several novel areas of nutritional intervention that are becoming increasingly important in gastrointestinal disease, including short-chain fatty acids, omega-3 polyunsaturated fatty acids and glutamine. Short-chain fatty acids are the principal end-products of bacterial fermentation of dietary fibers and have profound effects on normal intestinal cell metabolism and proliferation. Short-chain fatty acids have the potential to improve overall intestinal health, stimulate intestinal healing, and decrease intestinal inflammation. Omega-3 fatty acids, from dietary sources or supplements, may also be useful in decreasing intestinal inflammation and in preventing intestinal cancer. Finally, glutamine also may play an important role in the nutritional management of gastrointestinal disease. PMID:9842113

  13. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    International Nuclear Information System (INIS)

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  14. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    Energy Technology Data Exchange (ETDEWEB)

    Albers, Brittany K.; Garner, Hillary W. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Sluzevich, Jason C. [Mayo Clinic, Department of Dermatology, Jacksonville, FL (United States)

    2016-05-15

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  15. Nutritional support and gastrointestinal disease.

    Science.gov (United States)

    Hennessy, K

    1989-06-01

    The use of nutritional support in patients with acute gastrointestinal disease requires a thorough knowledge of the pathophysiology and nutritional alterations that are caused by the disease process. Although nutritional therapy of a patient with gastrointestinal disease is not curative of the underlying disease, it does provide essential support to the patient, which improves response to, and eventual recovery from, illness. Special considerations need to be made to avoid complicating the patient's condition by inappropriate use of nutritional support solutions, which can lead to abnormal liver function. PMID:2498848

  16. Pharmacological challenges in chronic pancreatitis

    DEFF Research Database (Denmark)

    Olesen, Anne Estrup; Brokjaer, Anne; Fischer, Iben Wendelboe Deleuran;

    2014-01-01

    Drug absorption in patients with chronic pancreatitis might be affected by the pathophysiology of the disease. The exocrine pancreatic insufficiency is associated with changes in gastrointestinal intraluminal pH, motility disorder, bacterial overgrowth and changed pancreatic gland secretion....... Together these factors can result in malabsorption and may also affect the efficacy of pharmacological intervention. The lifestyle of chronic pancreatitis patients may also contribute to gastrointestinal changes. Many patients limit their food intake because of the pain caused by eating and in some cases...... food intake is more or less substituted with alcohol, tobacco and coffee. Alcohol and drug interaction are known to influence the pharmacokinetics by altering either drug absorption or by affecting liver metabolism. Since patients suffering from chronic pancreatitis experience severe pain, opioids...

  17. Skin manifestations and comorbidities of chronic arsenicosis due to contaminated drinking water and their risk factors%慢性饮水型砷中毒患者皮肤表现和合并疾病及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    韩建文; 狄震; 张巧丽; 刘佳; 乌日嘎; 智艳平; 乌日娜

    2016-01-01

    目的:分析慢性饮水型砷中毒患者的皮肤表现、合并疾病以及可能的影响因素。方法对内蒙古95例慢性饮水型砷中毒患者的人口学特征、皮肤表现、合并疾病进行流行病学调查和分析。建立logistic回归模型,分析性别、年龄、开始饮用高砷水年龄、水砷浓度及饮用高砷水时间年龄与皮肤表现、合并疾病间的相关性。结果95例患者中共有77例患者发生色素沉着,75例发生色素减退,93例发生掌跖部皮肤角化,27例患者发生皮肤癌,其中多发性皮肤癌8例。合并结核5例、高血压15例、类风湿性关节炎2例、脑梗死4例、冠心病7例、内脏恶性肿瘤3例、肝硬化6例、贫血2例。回归分析发现色素沉着与水砷浓度相关(OR=0.32,95%CI=0.10~0.98);校正OR=0.27,95%CI=0.08~0.90)。冠心病的发生与饮用高砷水时间具有相关性(OR=6.41,95%CI=1.09~37.88;校正OR=8.55,95%CI=1.212~60.41)。肝硬化的发生与水砷浓度具有相关性(OR=24.67,95%CI=2.69~226.57;校正OR=22.51,95%CI=2.38~213.11)。结论慢性砷中毒患者色素代谢异常、掌跖部皮肤角化、皮肤癌发生率高。水砷浓度、饮用高砷水时间不同对人体可能产生不同的影响。%Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta⁃minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic⁃contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had

  18. Abdominal Manifestations of Lymphoma: Spectrum of Imaging Features

    International Nuclear Information System (INIS)

    Non-Hodgkin and Hodgkin lymphomas frequently involve many structures in the abdomen and pelvis. Extranodal disease is more common with Non-Hodgkin's lymphoma than with Hodgkin's lymphoma. Though it may be part of a systemic lymphoma, single onset of nodal lymphoma is not rare. Extranodal lymphoma has been described in virtually every organ and tissue. In decreasing order of frequency, the spleen, liver, gastrointestinal tract, pancreas, abdominal wall, genitourinary tract, adrenal, peritoneal cavity, and biliary tract are involved. The purpose of this review is to discuss and illustrate the spectrum of appearances of nodal and extranodal lymphomas, including AIDS-related lymphomas, in the abdominopelvic region using a multimodality approach, especially cross-sectional imaging techniques. The most common radiologic patterns of involvement are illustrated. Familiarity with the imaging manifestations that are diagnostically specific for lymphoma is important because imaging plays an important role in the noninvasive management of disease

  19. 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 ...

  20. Wegener’s granulomatosis mimicking inflammatory bowel disease and presenting with chronic enteritis

    Directory of Open Access Journals (Sweden)

    Shahedi K

    2013-10-01

    Full Text Available Kamyar Shahedi,1,2 Ramy Magdy Hanna,1,2 Oleg Melamed,1,2 James Wilson2,31Department of Medicine Olive-View UCLA Medical Center, Sylmar, CA, 2David Geffen School of Medicine at UCLA, Los Angeles, CA, 3UCLA Medical Center-UCLA Stone Center, Los Angeles, CA, USAAbstract: Wegener’s granulomatosis, also known as anti-neutrophil cytoplasmic antibody (ANCA-associated vasculitis, is a small vessel vasculitis with primarily pulmonary, renal, and sinus disease manifestations. The prevalence of Wegener’s granulomatosis is three cases per 100,000 patients. Cardiovascular, neurologic, cutaneous, and joint manifestations have been reported in many case reports and case series. Gastrointestinal manifestations are less noted in Wegener’s granulomatosis, although they have been previously reported in the form of intestinal perforation and intestinal ischemia. Additionally, there are characteristic findings of vasculitis that are noted with active Wegener’s granulomatosis of the small bowel. We report a case of an elderly patient who presented with weight loss, diarrhea, and hematochezia. His symptoms were chronic and had lasted for more than 1 year before diagnosis. Inflammatory bowel disease or chronic enteritis due to Salmonella arizonae because of reptile exposure originally were suspected as etiologies of his presentation. The findings of proteinuria, renal failure, and pauci-immune glomerulonephritis on renal biopsy, in conjunction with an elevated c-ANCA titer, confirmed the diagnosis of Wegener’s granulomatosis with associated intestinal vasculitis. This case demonstrates an atypical presentation of chronic duodenitis and jejunitis secondary to Wegener’s granulomatosis, which mimicked inflammatory bowel disease.Keywords: ANCA-associated vasculitis, Wegener’s syndrome, pauci-immune glomerulonephritis, Salmonella arizonae, inflammatory bowel disease

  1. Various clinical manifestations of brucellosis infection

    Directory of Open Access Journals (Sweden)

    Turkulov Vesna

    2008-01-01

    Full Text Available Introduction. Brucellosis is an acute, subacute or chronical disease, from the zoonosis group, caused by various types of bacteria belonging to genus Brucellae. It is transmitted to humans from domestic animals: goats, sheep, cattle, pigs and dogs. The course of the disease may either be asymptomatic, or produce a variety of clinical manifestations, ranging from light ones to extremely severe clinical forms. The aim of the study was to follow the clinical features of brucella infection in the hospital-treated patients, as well as its course and outcome. Material and Methods. The investigation included 15 patients, treated for brucella infection at the Clinic for infectious diseases during the last two years (2004 and 2005. Results. All patients were adults, their age ranged from 18 to 71, 49.96 on average. The epidemiological questionnaire was positive in all patients, confirming contacts with the ailing animals, or consumption of cheese made from milk of diseased animals. They all exhibited the classic symptoms - increased body temperature and shiver, fever, sweating, malaise and headache, the so called flu like state. The serum agglutination test was positive in respect to brucellosis, the titre ranged from 1:80 to 1:1280. Eight patients suffered excessive back pain, accompanied with impeded walk. In half of them magnetic resonance imaging confirmed the spondylodiscitis diagnosis. Three patients had clinical features of knee arthritis, two had bronchopneumonia, one pancreatitis, and one developed the signs of an acute kidney insufficiency. The outcome was favorable in all patients - They recuperated or healed completely. In one patient a relapse occurred, leading to the chronic course of the illness. Discussion. Although predominantly Mediterranean Brucellosis is a worldwide spread disease. During the last two years, an increased incidence of the disease has been observed. Conclusion. Due to the variety of clinical futures and the possibility

  2. Cardiac manifestations in systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Sevdalina; Lambova

    2014-01-01

    Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.

  3. Giant gastrointestinal stromal tumor of the stomach.

    Science.gov (United States)

    Ionescu, Sever; Barbu, Emil; Ionescu, Călin; Costache, Adrian; Bălăşoiu, Maria

    2015-01-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancies of the digestive tract. Gastric localization is the most frequent. The aim of this study is to evaluate the importance of immunohistochemical factors (CD117, CD34, α-SMA, vimentin, p53, Ki67) in diagnostic and size tumor and mitotic activity as prognostic factors for these tumors. We present the case of a 66-year-old male patient with a giant gastric GIST. Like in the vast majority, the symptomatology in this patient has long been faint, despite the large tumor size, and when it became manifest, it was nonspecific. Imagery wise, the computer tomography (CT) scan was the most efficient, showing the origin of the tumor from the greater curvature of the stomach, its dimensions, as well as the relations with the other abdominal viscera. Surgery in this patient was en-bloc, according to the principles of GIST. The histological aspect is characterized by a proliferation of spindle cells positive for CD117 and CD34. Despite complete microscopic resection, the size of the tumor (25×20×27 cm) and the mitotic activity (21÷5 mm2) remains important relapse factor.

  4. Neurological manifestation of colonic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Uzair Chaudhary

    2012-04-01

    Full Text Available Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

  5. Gastrointestinal anthrax: clinical experience in 5 cases

    OpenAIRE

    Maddah, Ghodratollah; ABDOLLAHI, ABBAS; Katebi, Mehrdad

    2013-01-01

    Background: Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. Thus, in this paper were report 5 cases of intestinal anthrax.

  6. Scintigraphic evaluation of gastrointestinal motility disorders

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Jae Gol [College of Medicine, Korea Univ., Seoul (Korea, Republic of)

    2001-02-01

    Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes after theraphy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy.

  7. Pulmonary manifestations of Sjögren's syndrome.

    Science.gov (United States)

    Flament, Thomas; Bigot, Adrien; Chaigne, Benjamin; Henique, Helene; Diot, Elisabeth; Marchand-Adam, Sylvain

    2016-06-01

    In 9-20% of cases, Sjögren's syndrome is associated with various respiratory symptoms. The most typical manifestations are chronic interstitial lung disease (ILD) and tracheobronchial disease. The most common manifestation of ILD is nonspecific interstitial pneumonia in its fibrosing variant. Other types of ILD, such as organising pneumonia, usual interstitial pneumonia and lymphocytic interstitial pneumonitis, are rare. Their radiological presentation is less distinctive, and definitive diagnosis may require the use of transbronchial or surgical lung biopsy. Corticosteroid therapy is the mainstay of ILD treatment in Sjögren's syndrome, but the use of other immunosuppressive drugs needs to be determined. ILD is a significant cause of death in Sjögren's syndrome. Tracheobronchial disease is common in Sjögren's syndrome, characterised by diffuse lymphocytic infiltration of the airway. It is sometimes responsible for a crippling chronic cough. It can also present in the form of bronchial hyperresponsiveness, bronchiectasis, bronchiolitis or recurrent respiratory infections. The management of these manifestations may require treatment for dryness and/or inflammation of the airways. Airway disease has little effect on respiratory function and is rarely the cause of death in Sjögren's syndrome patients. Rare respiratory complications such as amyloidosis, lymphoma or pulmonary hypertension should not be disregarded in Sjögren's syndrome patients. PMID:27246587

  8. Pulmonary manifestations of Sjögren's syndrome.

    Science.gov (United States)

    Flament, Thomas; Bigot, Adrien; Chaigne, Benjamin; Henique, Helene; Diot, Elisabeth; Marchand-Adam, Sylvain

    2016-06-01

    In 9-20% of cases, Sjögren's syndrome is associated with various respiratory symptoms. The most typical manifestations are chronic interstitial lung disease (ILD) and tracheobronchial disease. The most common manifestation of ILD is nonspecific interstitial pneumonia in its fibrosing variant. Other types of ILD, such as organising pneumonia, usual interstitial pneumonia and lymphocytic interstitial pneumonitis, are rare. Their radiological presentation is less distinctive, and definitive diagnosis may require the use of transbronchial or surgical lung biopsy. Corticosteroid therapy is the mainstay of ILD treatment in Sjögren's syndrome, but the use of other immunosuppressive drugs needs to be determined. ILD is a significant cause of death in Sjögren's syndrome. Tracheobronchial disease is common in Sjögren's syndrome, characterised by diffuse lymphocytic infiltration of the airway. It is sometimes responsible for a crippling chronic cough. It can also present in the form of bronchial hyperresponsiveness, bronchiectasis, bronchiolitis or recurrent respiratory infections. The management of these manifestations may require treatment for dryness and/or inflammation of the airways. Airway disease has little effect on respiratory function and is rarely the cause of death in Sjögren's syndrome patients. Rare respiratory complications such as amyloidosis, lymphoma or pulmonary hypertension should not be disregarded in Sjögren's syndrome patients.

  9. Pulmonary manifestations of Sjögren's syndrome

    Directory of Open Access Journals (Sweden)

    Thomas Flament

    2016-06-01

    Full Text Available In 9–20% of cases, Sjögren's syndrome is associated with various respiratory symptoms. The most typical manifestations are chronic interstitial lung disease (ILD and tracheobronchial disease. The most common manifestation of ILD is nonspecific interstitial pneumonia in its fibrosing variant. Other types of ILD, such as organising pneumonia, usual interstitial pneumonia and lymphocytic interstitial pneumonitis, are rare. Their radiological presentation is less distinctive, and definitive diagnosis may require the use of transbronchial or surgical lung biopsy. Corticosteroid therapy is the mainstay of ILD treatment in Sjögren's syndrome, but the use of other immunosuppressive drugs needs to be determined. ILD is a significant cause of death in Sjögren's syndrome. Tracheobronchial disease is common in Sjögren's syndrome, characterised by diffuse lymphocytic infiltration of the airway. It is sometimes responsible for a crippling chronic cough. It can also present in the form of bronchial hyperresponsiveness, bronchiectasis, bronchiolitis or recurrent respiratory infections. The management of these manifestations may require treatment for dryness and/or inflammation of the airways. Airway disease has little effect on respiratory function and is rarely the cause of death in Sjögren's syndrome patients. Rare respiratory complications such as amyloidosis, lymphoma or pulmonary hypertension should not be disregarded in Sjögren's syndrome patients.

  10. Oroal manifestations in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Grajales González Hilda María

    2014-07-01

    Full Text Available Multiple sclerosis is a chronic autoimmune inflammatory disease of the central nervous system, characterized by the presence of acute focal inflammatory demyelination, axonal loss and gliosis. It affects predominantly in young adults between 20 and 40 years of age; it is infrequent in the pediatric age. A observational, retrospective and descriptive cohort research was conducted between May 1999 and January 2012 to assess demographic characteristics, and pathological manifestations in the oral cav- ity of children with this condition. Records of 17 patients, under 18 years of age, of either sex were included, who had been evaluated in the Department of Stomatology. Data recorded were age, sex, State of origin, oral and facial pathological features, focal cavity infections and ceod index. There were no patients with trigeminal neuralgia or facial paralysis; a 5.7% ceod index was identified. Most of the patients were under immunopressive treatment. A protocol for stomatological follow-up in patients with multiple sclerosis does not exist. The medical profession must be sensibilized to establish strategies for an integral follow-up in patients with this condition.

  11. Extrahepatic Manifestations and Autoantibodies in Patients with Hepatitis C Virus Infection

    Directory of Open Access Journals (Sweden)

    Takashi Himoto

    2012-01-01

    Full Text Available Patients with chronic hepatitis C virus (HCV infection frequently have many extrahepatic manifestations, as persistent HCV infection often triggers lymphoproliferative disorders and metabolic abnormalities. These manifestations primarily include autoimmune disorders such as cryoglobulinemia, Sjögren’s syndrome, and autoimmune thyroid disorders. It has been well established that chronic HCV infection plays important roles in the production of non-organ-specific autoantibodies, including antinuclear antibodies and smooth muscle antibodies, and organ-specific autoantibodies such as thyroid autoantibodies. However, the clinical significance of autoantibodies associated with the extrahepatic manifestations caused by HCV infection has not been fully recognized. In this paper, we mainly focus on the relationship between extrahepatic manifestations and the emergence of autoantibodies in patients with HCV infection and discuss the clinical relevance of the autoantibodies in the extrahepatic disorders.

  12. Gastrointestinal Manifestations of Hereditary Angioedema Diagnosed by Ultrasound in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Christine Riguzzi

    2014-11-01

    Full Text Available Abdominal angioedema is a less recognized type of angioedema, which can occur in patients with hereditary angioedema (HAE. The clinical signs may range from subtle, diffuse abdominal pain and nausea, to overt peritonitis. We describe two cases of abdominal angioedema in patients with known HAE that were diagnosed in the emergency department by point-of-care (POC ultrasound. In each case, the patient presented with isolated abdominal complaints and no signs of oropharyngeal edema. Findings on POC ultrasound included intraperitoneal free fluid and bowel wall edema. Both patients recovered uneventfully after receiving treatment. Because it can be performed rapidly, requires no ionizing radiation,and can rule out alternative diagnoses, POC ultrasound holds promise as a valuable tool in the evaluation and management of patients with HAE. [West J Emerg Med. 2014;15(7:-0.

  13. Cutaneous manifestations of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Al Roujayee Abdulaziz

    2007-01-01

    Full Text Available Inflammatory bowel disease (IBD has many extraintestinal manifestations, and skin lesions are one of the most frequently described extraintestinal findings. Reports indicate an incidence of cutaneous manifestations ranging from 2 to 34%, Cutaneous manifestations are usually related to the activity of the bowel disease but may have an independent course. In this review we aim to address the various cutaneous manifestations associated with IBD, their impact on the disease course, and the treatment options available.

  14. New technologies in gastrointestinal research

    Institute of Scientific and Technical Information of China (English)

    Asbjφrn Mohr Drewes; Hans Gregersen

    2009-01-01

    This issue presents different new techniques aiming to increase our understanding of the gastrointestinal system and to improve treatment. The technologies cover selected methods to evoke and assess gut pain, new methods for imaging and physiological measurements, histochemistry, pharmacological modelling etc. There is no doubt that the methods will revolutionize the diagnostic approach in near future.

  15. Cutaneous manifestations of internal malignancy

    Directory of Open Access Journals (Sweden)

    A Ayyamperumal

    2012-01-01

    Full Text Available Background: Many malignancies affecting the internal organs display cutaneous manifestations which may be either specific (tumor metastases or nonspecific lesions. Aims: The study is aimed at determining the frequency and significance of cutaneous manifestations among patients with internal malignancy. Materials and Methods: 750 cases of proven internal malignancy, who attended a cancer chemotherapy center in South India, were studied. Specific infiltrates were confirmed by histopathology, fine needle aspiration cytology (FNAC and marker studies. Results: Out of the 750 patients with internal malignancy, skin changes were seen in a total of 52 (6.93% patients. Conclusion: Cutaneous metastases (specific lesions were seen in 20 patients (2.66%: contiguous in 6 (0.8%, and non-contiguous in 14 (1.86%. Nonspecific skin changes were seen in 32 patients (4.26%. None of our patients presented with more than one type of skin lesions. Herpes zoster was the most common nonspecific lesion noticed in our patients, followed by generalized pruritus, multiple eruptive seborrheic keratoses, bullous disorder, erythroderma, flushing, purpura, pyoderma gangrenosum, insect bite allergy and lichenoid dermatitis.

  16. Atypical Manifestation of Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Webster, Guilherme

    2013-09-01

    Full Text Available Introduction: Vestibular schwannoma (also known as acoustic neuroma is a benign tumor whose cells are derived from Schwann sheaths, which commonly occurs from the vestibular portion of the eighth cranial nerve. Furthermore, vestibular schwannomas account for ∼8% of intracranial tumors in adults and 80 to 90% of tumors of the cerebellopontine angle. Its symptoms are varied, but what stands out most is a unilateral sensorineural hearing loss, with a low index of speech recognition. Objective: Describe an atypical manifestation of vestibular schwannoma. Case Report: The 46-year-old woman had vertigo and binaural hearing loss and fullness, with ear, nose, and throat examination suggestive of cochlear injury. After 6 months, the patient developed worsening of symptoms and onset of right unilateral tinnitus. In further exams the signs of cochlear damage remained, except for the vestibular test (hyporeflexia. Magnetic resonance imaging showed an expansive lesion in the right cerebellopontine angle. Discussion: This report warns about the atypical manifestations of vestibular schwannoma, which must always be remembered in investigating and diagnosing hearing loss.

  17. Inhibitory effect of pinaverium bromide on gastrointestinal contractile activity in conscious dogs.

    Science.gov (United States)

    Itoh, Z; Takahashi, I

    1981-01-01

    The inhibitory effect of 4-(6-bromoveratryl)-4-(2-[2-(6,6-dimethyl-2-norpinyl)-ethoxy]-ethyl)-morpholinium hydroxide (pinaverium bromide), a quaternary ammonium derivative, on the contractile activity of the gastrointestinal tract from the stomach to the colon was investigated in six conscious dogs. Gastrointestinal motor activity was monitored by means of chronically implanted force transducers. Pinaverium bromide was continuously administered i.v. for 30 min in doses of 10 and 20 mg/kg/h during both the digestive and interdigestive states. It was found that pinaverium bromide strongly inhibited gastrointestinal contractile activity during both the digestive and interdigestive states; contractions in the stomach were most strongly inhibited; however, those in the small and large bowels were also significantly inhibited. No significant side effects in the circulatory and respiratory systems and the gastrointestinal tract such as nausea, vomiting or diarrhea were observed during and after the infusion of this agent. PMID:7197953

  18. Validation of the Revised Children's Manifest Anxiety Scale, Second Edition (RCMAS-2) Scores for Children with Specific Learning Disabilities

    Science.gov (United States)

    Raad, Jennifer M.

    2013-01-01

    Specific learning disabilities are one of the most common and debilitating disorders experienced by children and adolescents, and students with specific learning disabilities may be particularly vulnerable to anxiety. The Revised Children's Manifest Anxiety Scale, Second Edition (RCMAS-2) is a newly revised measure of chronic, manifest anxiety…

  19. 加味四逆散对身心应激模型大鼠胃粘膜超微结构及胃肠功能的影响%Effects of Jia-Wei-Si-Ni-San on Gastrointestinal Function and Gastric Mucosal Ultrastructure of Chronic Psychological Stress Rats Models

    Institute of Scientific and Technical Information of China (English)

    谢慧臣; 刘芬; 杨强

    2013-01-01

    目的:研究加味四逆散(JWSNS)对模型大鼠胃粘膜超微结构、胃排空率及小肠推进比的影响,探讨JWSNS干预应激性胃肠功能障碍的机制.方法:大鼠随机分为正常组,模型组,加味四逆散大、中、小剂量组,西沙比利组,采用慢性心理性应激方法建立应激性胃溃疡大鼠模型,经JWSNS等干预后,采用透射电镜法观察腺胃区胃粘膜组织细胞及细胞间连接的超微结构改变,并检测胃肠动力变化.结果:电镜观察显示正常组大鼠胃粘膜上皮细胞间连接紧凑,胞膜完整,细胞器均匀分布,且形态正常,胞核形态及大小正常,核膜完整,无染色质浓缩、边集等异常;模型组大鼠胃粘膜上皮细胞间连接松解,胞膜结构部分缺失,胞质中细胞器崩解,基质透明,内质网扩张,线粒体肿胀,胞核形态极不规则,大量畸形核,部分核溶解,染色质明显边集、浓缩或均一化分布;其余治疗组均较模型组不同程度好转.与模型组比较,各治疗组及正常组胃排空率及小肠推进比均明显升高(P<0.05~0.01);与西沙比利组比较,加味四逆散大剂量组胃排空率升高不明显(P>0.05),而小肠推进比升高明显(P<0.05);与加味四逆散小剂量组比较,加味四逆散中、大剂量组胃排空率及小肠推进比升高明显(P<0.05~0.01).结论:JWSNS可显著改善慢性心理应激胃溃疡模型大鼠胃粘膜组织细胞的微观病理形态,并可改善胃肠功能.%This study was aimed to establish a chronic rat model of acute stress ulcer, and observe effect of Jia-Wei-Si-Ni-San (JWSNS) on gastric emptying rate and small intestinal propulsion ratio, gastric mucosal ultra-structure of rat model. The mechanism of JWSNS on the treatment of stress-induced gastrointestinal dysfunction was studied. Rats were randomly divided into the normal group, model group, JWSNS large dosage, medium dosage and small dosage group, Cisapride group. Stress gastric ulcer

  20. Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation

    OpenAIRE

    Tateno, Fuyuki; Sakakibara, Ryuji; Kawashima, Kengo; Kishi, Masahiko; Tsuyusaki, Yohei; Aiba, Yosuke; Ogata, Tsuyoshi

    2014-01-01

    It is rare that amyotrophic lateral sclerosis (ALS) presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness.

  1. Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation

    Directory of Open Access Journals (Sweden)

    Fuyuki Tateno

    2014-08-01

    Full Text Available It is rare that amyotrophic lateral sclerosis (ALS presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness.

  2. Central nervous system vasculitis and polyneuropathy as first manifestations of hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Roberto J Carvalho-Filho; Janaína Luz Narciso-Schiavon; Luciano HL Tolentino; Leonardo L Schiavon; Maria Lucia G Ferraz; Antonio Eduardo B Silva

    2012-01-01

    Sensory or motor peripheral neuropathy may be observed in a significant proportion of hepatitis C virus (HCV)-infected patients. However, central nervous system (CNS) involvement is uncommon, especially in cryoglobulin-negative subjects. We describe a case of peripheral neuropathy combined with an ischemic CNS event as primary manifestations of chronic HCV infection without cryoglobulinemia. Significant improvement was observed after antiviral therapy. We discuss the spectrum of neurological manifestations of HCV infection and review the literature.

  3. Connection between inflammation and carcinogenesis in gastrointestinal tract: Focus on TGF-β signaling

    Institute of Scientific and Technical Information of China (English)

    Suntaek; Hong; Ho-Jae; Lee; Seong; Jin; Kim; Ki-Baik; Hahm

    2010-01-01

    Inflammation is a primary defense process against various extracellular stimuli,such as viruses,pathogens,foods,and environmental pollutants.When cells respond to stimuli for short periods of time,it results in acute or physiological inflammation.However,if the stimulation is sustained for longer time or a pathological state occurs,it is known as chronic or pathological inflammation.Several studies have shown that tumorigenesis in the gastrointestinal (GI) tract is closely associated with chronic inflammati...

  4. Vascular manifestations of Behcet's disease

    Directory of Open Access Journals (Sweden)

    Regina Georgiyeva Goloeva

    2010-04-01

    Conclusion. Vascular disorders in BD were diagnosed in one fourth of the patients, mainly in young male patients. Severe thromboses with the development of chronic venous insignificance, Budd-Chiari syndrome, pulmonary and iliac artery aneurysms, and arterial thromboses were observed in male patients only. Vascular events were associated with erythema nodosum and epididymitis; in these concomitances, the vascular risk was substantially increased. Vascular death rates were 2,2%.

  5. CT manifestations of ileal dysgenesis

    Energy Technology Data Exchange (ETDEWEB)

    Oberhelman, Amy P.; Herman, Thomas E.; McAlister, William H. [St. Louis Children' s Hospital, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Department of Radiology, St. Louis, MO (United States); Keating, James P. [St. Louis Children' s Hospital, Mallinckrodt Department of Pediatrics, Washington University School of Medicine, Division of Gastroenterology, St. Louis, MO (United States); Rollins, Michael D.; Dillon, Patrick A. [St. Louis Children' s Hospital, Department of Surgery, Washington University School of Medicine, St. Louis, MO (United States)

    2007-02-15

    Ileal dysgenesis is an uncommon condition of unknown etiology occurring in the distal ileum in the region of the vitelline duct. The CT appearance of this lesion, although not previously described to our knowledge, is characteristic. We report a patient with ileal dysgenesis who had an abdominal CT scan to evaluate chronic iron deficiency anemia and protein-losing enteropathy. Recognition of this lesion by pediatric radiologists is important; so that surgical treatment, which is simple and effective, can be initiated quickly. (orig.)

  6. Streptococcus suis infection: Clinical manifestations

    Directory of Open Access Journals (Sweden)

    Dragojlović Julijana

    2005-01-01

    Full Text Available Introduction Streptococcus suis is a bacterium causing a disease in pigs and rarely in humans. This zoonosis is mostly found as a sporadic disease in individuals that were in contact with the affected or infected pigs: farmers, veterinarians and workers engaged in fresh pork processing. It is assumed that the bacterium enters the body through a cut abrasion in the skin. Initially, the condition resembles a flu, followed by signs of bacteriemia and sepsis. The most frequent clinical manifestation of Streptococcus suis infection is meningitis, leading to hearing loss in over 75% of patients, and subsequent arthritis, endophtalmitis, endocarditis and pneumonia. Toxic shock syndrome with hemorhagic manifestations rarely develops. Material and methods This study included five male patients aged 22 to 63 years treated in the Intensive Care Unit of the Institute of Infectious and Tropical Diseases in Belgrade, due to Streptococcus suis infection. The aim of this study was to point to the existence of this bacteria in our environment, to describe clinical manifestations of the disease and to point out the importance of its prevention. Results All patients had epidemiological evidence of being in contact with pork meat. There were no data about diseased pigs. The estimated incubation period was 4 to 8 days. All patients had meningeal signs. Clinical symptoms included shivering, fever, vomiting, headache, malaise, vertigo and tinitus. Three patients presented with alerterd level of awareness. Four patients developed very severe bilateral hearing impairemnt, whereas one endophtalmtis and one developed endocarditis. The cerebrospinal fluid (CSF was opalescent in four patients, and only one patient presented with clear CSF. CSF examination showed typical changes characeteristic for bacterial meningitis. Streptoccocus suis was isolated in CSF in all patients, and in one patient the bacteria was isolated in blood as well. All patients underwent treatment with

  7. Analysis of clinical manifestations of symptomatic acquired jejunoileal diverticular disease

    Institute of Scientific and Technical Information of China (English)

    Chia-Yuan Liu; Wen-Hsiung Chang; Shee-Chan Lin; Cheng-Hsin Chu; Tsang-En Wang; Shou-Chuan Shih

    2005-01-01

    AIM: To analyze systematically our experience over 22 years with symptomatic acquired diverticular disease of the jejunum and ileum, exploring the clinical manifestations and diagnosis of this rare but life-threatening disease.METHODS: The medical records of patients with surgically confirmed symptomatic jejunoileal diverticular disease were retrospectively reviewed. Data collected included demographic data, laboratory results, clinical course (acute or chronic), preoperative diagnosis, and operative findings. Inclusion criteria were as follows: (1) surgical confirmation of jejunoileal diverticular disease and (2)exclusion of congenital diverticula (e.g. Meckel's diverticulum).RESULTS: From January 1982 to July 2004, 28 patients with a total of 29 operations met the study criteria. The male:female ratio was 14:14, and the mean age was 62.6±3.5 years. The most common manifestation was abdominal pain. In nearly half of the patients, the symptoms were chronic. Two patients died after surgery. Only four cases were correctly diagnosed prior to surgery, three by small bowel series.CONCLUSION: Symptomatic acquired small bowel diverticular disease is difficult to diagnose. It should be considered in older patients with unexplained chronic abdominal symptoms. A small bowel series may be helpful in diagnosing this potentially life-threatening disease.

  8. Atypical manifestations of early syphilis

    Directory of Open Access Journals (Sweden)

    Koranne R

    1990-01-01

    Full Text Available A study of 36 untreated patients with early syphilis revealed atypical variations namely; long incubation period of 101 days in I patient, more than 3 chancres in 1, undermined margin of the chancre along with tenderness in 1 and moderate to severe tenderness of the ulcers in 2 cases. In 3 patients there was no indurations of the ulcers. Three patients with primary syphilis had unilateral lymphadenitis, and in I case the lymph nodes were not only tender but showed tendency towardsmatingawell. Insecondarysyphilis, 11 out of 16 patients having condylomata lata had no other muco-cutaneous lesions. Concomitant presence of other venereal disease to account for the atypical manifestations was discounted- by appropriate laboratory tests, response to therapeutic agents and follow up.

  9. [Purpura: primary systemic amyloidosis manifestation].

    Science.gov (United States)

    Lestre, Sara; Gonçalves, Andreia; João, Alexandre; Ferreira, Ana; Apetato, Margarida

    2009-01-01

    Primary Systemic Amyloidosis (AL) is the most frequent form of systemic amyloidosis and its morbilility is associated with immunoglobulin light chains deposition in vital organs. The mucocutaneous manifestations occur in about 30-40% of the cases and are important in diagnostic suspicion, once they appear in early stages of disease. We report a 71-years-old female patient, with disseminated purpura and cutaneous fragility with 6 months of evolution, accompanied by recent complaints of dysphagy. The first laboratory evaluation didn't show any alterations. The histological and immunohistochemical study of subcutaneous abdominal fat and skin biopsy showed lambda type amyloid protein. In the systemic work-up, we highlight a proteinúria > 1g/24h with Bence Jones proteins and the presence of monoclonal immunoglobulin light chain (lambda type) in serum immunoelectrophoresis. With the diagnosis of primary systemic amyloidosis, treatment with prednisolone and melphalan was started. PMID:19686633

  10. Cutaneous manifestations of hepatitis C in the era of new antiviral agents

    Institute of Scientific and Technical Information of China (English)

    Simone; Garcovich; Matteo; Garcovich; Rodolfo; Capizzi; Antonio; Gasbarrini; Maria; Assunta; Zocco

    2015-01-01

    The association of chronic hepatitis C virus(HCV) infection with a wide spectrum of cutaneous manifestations has been widely reported in the literature, with varying strength of epidemiological association. Skin diseases which are certainly related with chronic HCV infection due to a strong epidemiological and pathogenetic association are mixed cryoglobulinemia, lichen planus and porphyria cutanea tarda. Chronic pruritus and necrolytic acral erythema are conditions that may share a possible association with HCV infection, while several immune-mediated inflammatory skin conditions, such as psoriasis, chronic urticaria and vitiligo, have been only anecdotally reported in the setting of chronic HCV infection. Traditional interferonbased treatment regimens for HCV infection are associated with substantial toxicity and a high-risk of immune-related adverse events, while the advent of new direct-acting antivirals with sustained virological response and improved tolerability will open the door for all-oral, interferon-free regimens. In the new era of these direct acting antivirals there will be hopefully a renewed interest in extra-hepatic manifestations of HCV infection. The aim of the present paper is to review the main cutaneous HCV-related disorders- mixed cryoglobulinemia, lichen planus, porphyria cutanea tarda and chronic pruritus- and to discuss the potential impact of new antiviral treatments on the course of these extrahepatic manifestations of chronic HCV infection.

  11. Chronic arsenic poisoning.

    Science.gov (United States)

    Hall, Alan H

    2002-03-10

    Symptomatic arsenic poisoning is not often seen in occupational exposure settings. Attempted homicide and deliberate long-term poisoning have resulted in chronic toxicity. Skin pigmentation changes, palmar and plantar hyperkeratoses, gastrointestinal symptoms, anemia, and liver disease are common. Noncirrhotic portal hypertension with bleeding esophageal varices, splenomegaly, and hypersplenism may occur. A metallic taste, gastrointestinal disturbances, and Mee's lines may be seen. Bone marrow depression is common. 'Blackfoot disease' has been associated with arsenic-contaminated drinking water in Taiwan; Raynaud's phenomenon and acrocyanosis also may occur. Large numbers of persons in areas of India, Pakistan, and several other countries have been chronically poisoned from naturally occurring arsenic in ground water. Toxic delirium and encephalopathy can be present. CCA-treated wood (chromated copper arsenate) is not a health risk unless burned in fireplaces or woodstoves. Peripheral neuropathy may also occur. Workplace exposure or chronic ingestion of arsenic-contaminated water or arsenical medications is associated with development of skin, lung, and other cancers. Treatment may incklude the use of chelating agents such as dimercaprol (BAL), dimercaptosuccinic acid (DMSA), and dimercaptopanesulfonic acid (DMPS).

  12. Gastrointestinal hormones and their targets

    DEFF Research Database (Denmark)

    Rehfeld, Jens F.

    2014-01-01

    , paracrine, spermiocrine secretion etc.), so the same peptide may act as a blood-borne hormone, a neurotransmitter, a local growth factor, or a fertility factor. The molecular targets of each bioactive peptide are specific G-protein coupled receptors expressed in the cell membranes of different target cells......Gastrointestinal hormones are peptides released from endocrine cells and neurons in the digestive tract. More than 30 hormone genes are currently known to be expressed in the gastrointestinal tract, which makes the gut the largest hormone producing organ in the body. Modern biology makes...... it feasible to conceive the hormones under five headings: The structural homology groups a majority of the hormones into nine families, each of which is assumed to originate from one ancestral gene. The individual hormone gene often has multiple phenotypes due to alternative splicing, tandem organization...

  13. Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children

    Science.gov (United States)

    Slepov, Oleksii; Kurinnyi, Sergii; Ponomarenko, Oleksii; Migur, Mikhailo

    2016-01-01

    Background: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. Materials and Methods: The patients’ records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome. Results: Since 1995 to 2014 we observed 6 (3 boys, 3 girls) patients with CDHM, that comprise 3.2% of all congenital diaphragmatic hernia cases (n = 185). Age at diagnosis varied from 3 mo. to 10y.o. Failure to thrive was main symptom in 4 patients, followed by recurrent respiratory infections (n = 3), dyspnea (n = 3), and gastrointestinal manifestations: constipation (n = 2), abdominal pain (n = 1). Work-up consisted of plain X-ray for all (n = 6), upper GI (n = 3), barium enema (n = 2), sonography (n = 6) and CT (n = 2). Abdominal approach used in 5 patients, and thoracotomy in one. Herniated contents were: liver lobes (n = 4), transverse colon (n = 3) and greater omentum (n = 1). 5 had right-sided lesion, 1- left-sided. Defect repaired using local tissues. Post-operative course was uneventful; all patients appeared well during follow-up. Conclusion: CDHM is very uncommon anomaly, very occasionally diagnosed at the early age. Failure to thrive and recurrent respiratory infections are most frequent clinical manifestations. In suspected CDHM we advocate the following work-up: plain chest and abdominal X-ray, contrast study (upper GI series or barium enema), ultrasonographic screen and CT scan. Surgical repair via abdominal approach, using local tissues and hernia sac removal is preferred. PMID:27251653

  14. [Juvenil idiopathic arthritis. Part 1: diagnosis, pathogenesis and clinical manifestations].

    Science.gov (United States)

    Espada, Graciela

    2009-10-01

    Juvenile idiopathic arthritis is not a single disease and constitutes an heterogeneous group of illnesses or inflammatory disorders. This new nomenclature encompasses different disease categories, each of which has different presentation, clinical signs, symptoms, and outcome. The cause of the disease is still unknown but both environmental and genetic factors seem to be related to its pathogenesis. Is the most common chronic rheumatic disease in children and an important cause of short-term and long-term disability. In this article, clinical manifestation, new classification and approach to diagnosis are reviewed.

  15. Visceral Pain and Gastrointestinal Microbiome

    OpenAIRE

    Chichlowski, Maciej; Rudolph, Colin

    2015-01-01

    A complex set of interactions between the microbiome, gut and brain modulate responses to visceral pain. These interactions occur at the level of the gastrointestinal mucosa, and via local neural, endocrine or immune activity; as well as by the production of factors transported through the circulatory system, like bacterial metabolites or hormones. Various psychological, infectious and other stressors can disrupt this harmonious relationship and alter both the microbiome and visceral pain res...

  16. The Gastrointestinal Aspects of Halitosis

    OpenAIRE

    Kinberg, Sivan; Stein, Miki; Zion, Nataly; Shaoul, Ron

    2010-01-01

    BACKGROUND: Halitosis is a common human condition for which the exact pathophysiological mechanism is unclear. It has been attributed mainly to oral pathologies. Halitosis resulting from gastrointestinal disorders is considered to be extremely rare. However, halitosis has often been reported among the symptoms related to Helicobacter pylori infection and gastroesophageal reflux disease.OBJECTIVE: To retrospectively review the experience with children and young adults presenting with halitosis...

  17. Upper gastrointestinal physiology and diseases.

    Science.gov (United States)

    Waldum, Helge L; Kleveland, Per M; Fossmark, Reidar

    2015-06-01

    Nordic research on physiology and pathophysiology of the upper gastrointestinal tract has flourished during the last 50 years. Swedish surgeons and physiologists were in the frontline of research on the regulation of gastric acid secretion. This research finally led to the development of omeprazole, the first proton pump inhibitor. When Swedish physiologists developed methods allowing the assessment of acid secretion in isolated oxyntic glands and isolated parietal cells, the understanding of mechanisms by which gastric acid secretion is regulated took a great step forward. Similarly, in Trondheim, Norway, the acid producing isolated rat stomach model combined with a sensitive and specific method for determination of histamine made it possible to evaluate this regulation qualitatively as well as quantitatively. In Lund, Sweden, the identification of the enterochromaffin-like cell as the cell taking part in the regulation of acid secretion by producing and releasing histamine was of fundamental importance both physiologically and clinically. Jorpes and Mutt established a center at Karolinska Institutet in Stockholm for the purification of gastrointestinal hormones in the 1960s, and Danes followed up this work by excelling in the field of determination and assessment of biological role of gastrointestinal hormones. A Finnish group was for a long period in the forefront of research on gastritis, and the authors' own studies on the classification of gastric cancer and the role of gastrin in the development of gastric neoplasia are of importance. It can, accordingly, be concluded that Nordic researchers have been central in the research on area of the upper gastrointestinal physiology and diseases. PMID:25857514

  18. Never events in gastrointestinal nursing

    OpenAIRE

    Cox, C. L.

    2011-01-01

    Gastrointestinal diseases and disorders frequently require interventions that can lead to serious consequences for patients when an organization has not put in place the correct systems and processes to prevent incidents from happening, procedures have not been followed (generally due to poor observation), or when an individual disregards protocol (generally due to lack of judgment). It has been identified that over 400,000 patients suffer potentially preventable harmful events each year (Ems...

  19. Rare gastrointestinal lymphomas: the endoscopicinvestigation

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Gastrointestinal lymphomas represent up to 10% ofgastrointestinal malignancies and about one third of non-Hodgkin lymphomas. The most prominent histologies aremucosa-associated lymphoid tissue lymphoma and diffuselarge B-cell lymphoma. However, the gastrointestinaltract can be the site of rarer lymphoma subtypes as aprimary or secondary localization. Due to their rarity andthe multifaceted histology, an endoscopic classificationhas not been validated yet. This review aims to analyzethe endoscopic presentation of rare gastrointestinallymphomas from disease diagnosis to follow-up,according to the involved site and lymphoma subtype.Existing, new and emerging endoscopic technologieshave been examined. In particular, we investigated thediagnostic, prognostic and follow-up endoscopic featuresof T-cell and natural killer lymphomas, lymphomatouspolyposis and mantle cell lymphoma, follicular lymphoma,plasma cell related disease, gastrointestinal lymphomasin immunodeficiency and Hodgkin's lymphoma ofthe gastrointestinal tract. Contrarily to more frequentgastrointestinal lymphomas, data about rare lymphomasare mostly extracted from case series and casereports. Due to the data paucity, a synergism betweengastroenterologists and hematologists is required in order to better manage the disease. Indeed, clinicaland prognostic features are different from nodal andextranodal or the bone marrow (in case of plasma celldisease) counterpart. Therefore, the approach shouldbe based on the knowledge of the peculiar behavior andnatural history of disease.

  20. Musculoskeletal manifestations of Lyme disease.

    Science.gov (United States)

    Steere, A C

    1995-04-24

    Musculoskeletal involvement, particularly arthritis, is a common feature of Lyme disease. Early in the illness, patients may experience migratory musculoskeletal pain in joints, bursae, tendons, muscle, or bone in one or a few locations at a time, frequently lasting only hours or days in a given location. Weeks to months later, after the development of a marked cellular and humoral immune response to the spirochete, untreated patients often have intermittent or chronic monoarticular or oligoarticular arthritis-primarily in large joints, especially the knee-during a period of several years. The diagnosis of Lyme arthritis is usually based on the presence of this characteristic clinical picture, exposure in an endemic area, and an elevated immunoglobulin G antibody response to Borrelia burgdorferi. In addition, spirochetal DNA can often be detected in joint fluid by polymerase chain reaction. Lyme arthritis can usually be treated successfully with 1-month courses of oral doxycycline or amoxicillin or with 2- to 4-week courses of intravenous ceftriaxone. However, patients with certain genetic and immune markers may have persistent arthritis, despite treatment with oral or intravenous antibiotics. B. burgdorferi may occasionally trigger fibromyalgia, a chronic pain syndrome with diffuse joint and muscle symptoms. This syndrome does not appear to respond to antibiotic therapy.

  1. Impacts of chronic hepatitis B virus co-infection on immune responses and clinical manifestations in acute infection of dengue virus type 1%合并慢性乙型肝炎病毒感染对登革病毒1型急性感染者免疫应答和临床的影响

    Institute of Scientific and Technical Information of China (English)

    唐漾波; 张复春; 曹孟丽; 姚细安; 唐小平

    2011-01-01

    目的 了解合并慢性HBV感染对急性登革病毒感染引起的免疫应答和临床的影响.方法 采用ELISA法同时检测了310例登革病毒1型感染患者血清中IFNα、IFNβ、IFNγ、IL-10和TNFα等细胞因子水平,其中8%(25/310)合并感染了HBV,对照组的血清标本取自41名健康者和47例慢性HBV感染患者.多组比较采用单因素方差分析,检测指标的相关性分析采用Spearman等级相关检验.结果 在急性登革病毒感染期间,IFNα分泌水平显著高于IFNβ,分别为(95.1±279.3) pg/mL和(2.8土16.2)pg/mL,但在合并HBV感染的患者中IFNα的分泌明显减少,为(86.5±358.1) pg/mL;分别在发热第2天、第3~4天和第6天,IFNα、IFNβ及IL-10的中位数达到峰值.在单纯登革病毒感染的患者中,IFNα水平与血小板计数和血清ALT水平呈负相关(分别为r=-0.2327,-0.2122,均P<0.01).结论 合并慢性HBV感染可以改变急性登革病毒感染引起的免疫反应;IFNα的分泌可能与出血倾向相关,但对肝脏的炎性损伤可能起保护作用.%Objective To investigate impacts of chronic hepatitis B virus (HBV) co-infection on immune responses and clinical manifestations in acute infection of dengue virus type 1.Methods The serum levels of interferon (IFN)a,IFNβ,IFNγ,interleukin (IL)-10 and tumor necrosis factor (TNF)α of 310 dengue serotype 1 (DENV1)-infected patients were assessed by enzyme linked immunosorbent assay (ELISA),among which 8% (25/310) were chronic HBV co-infection.Meanwhile,serum samples from 41 healthy adults and 47 chronic HBV infected subjects were recruited as controls.Comparisons among groups were done by one factor analysis of variance and correlation analysis of results was done by spearman rank correlation test.Results The serum level of IFN-α [(95.1 ± 279.3) pg/mL] was significantly higher than IFN-β[(2.8 ± 16.2) pg/mL] during acute dengue infection,while IFN-α level [(86.5±358.1) pg/mL] reduced in patients with HBV

  2. Clinicoepidemiologic features of chronic urticaria in patients having positive versus negative autologous serum skin test: A study of 100 Indian patients

    Directory of Open Access Journals (Sweden)

    Surbhi Vohra

    2011-01-01

    Full Text Available Background: Chronic urticaria patients who demonstrate autoantibodies against the high-affinity receptor of IgE (FceRI or IgE itself tend to have a high itch and wheal score, and systemic symptoms may have a significant bearing on their management in terms of super pharmacologic doses of antihistamines needed or use of immunomodulators. Most studies have used histamine release assays rather than autologous serum skin tests (ASSTs for correlating urticaria severity and histamine releasing activity. Methods: An ASST was performed in 100 (M:F, 31:69 chronic urticaria patients aged between 14 and 63 (mean, 32.69 ± 13 years with an objective to study the clinicoepidemiologic features like age, sex, age of onset and duration, frequency and distribution of wheals, urticaria severity, angioedema and systemic manifestations in ASST-positive and ASST-negative patients. Results: ASST was positive in 46% of the patients and negative in 54% of the patients, respectively. Both groups showed no statistically significant difference for epidemiological details. However, the ASST-positive patients had a higher mean urticaria activity score, frequent involvement of more body sites, particularly palms and soles, presence of throat angioedema and general constitutional, respiratory or gastrointestinal symptoms in comparison with the ASST-negative patients. Conclusions: Apparently, ASST-positive patients have more severe clinical manifestations of chronic urticaria. The knowledge will be useful for the treating dermatologists and patients alike in view of its therapeutic implications.

  3. EMPIRIC THERAPY IN OTOLARYNGOLOGIC MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE

    Directory of Open Access Journals (Sweden)

    M. Mohammadi

    2005-04-01

    Full Text Available The review of literature shows that a strong relationship exists between the symptoms of otolaryngologic diseases and gastroesophageal reflux disease (GERD. It is commonly observed that an extended physical examination is needed to determine the occurrence of GERD. This non-randomized,prospective quasi-experimental study was performed to clinically verify the relationship between otolaryngologic symptoms and GERD and to show that a search for GERD is necessary under conditions that patients do not respond to initial routine treatment for otolaryngologic symptoms. Extended physical examination of patients who had been referred to an Ear, Nose and throat (ENThospital revealed that GERD-related laryngeal signs were present in 55 patients. Otolaryngologic symptoms detected in decreasing order of occurrence were posterior nasal drip, chronic pharyngitis, chronic cough, hoarseness, ear pain, chronic throat clearing and pruritus in the ear. Furthermore, 66% of the patients had gastrointestinal symptoms that included heartburn, dysphagia, odynophagia, aspiration, globus hystericus, dyspepsia and foreign body sensation. Signs observed during the physical examination were posterior pharyngitis, granular pharyngitis, inflamed arytenoids, contact granuloma, and pachyderma laryngitis. We administered proton pump inhibitor to all patients and recommended to change their life style. The follow up program was a 6-month period. Only 53 patients showed up for the follow up. The overall response rate to the therapeutic regimen was 83%. In treating otolaryngologic patients, especially those who are resistant to routine treatments, a careful extended physical examination including an indirect laryngoscopy for diagnosis of GERD is recommended.

  4. Ultrasound-mediated gastrointestinal drug delivery.

    Science.gov (United States)

    Schoellhammer, Carl M; Schroeder, Avi; Maa, Ruby; Lauwers, Gregory Yves; Swiston, Albert; Zervas, Michael; Barman, Ross; DiCiccio, Angela M; Brugge, William R; Anderson, Daniel G; Blankschtein, Daniel; Langer, Robert; Traverso, Giovanni

    2015-10-21

    There is a significant clinical need for rapid and efficient delivery of drugs directly to the site of diseased tissues for the treatment of gastrointestinal (GI) pathologies, in particular, Crohn's and ulcerative colitis. However, complex therapeutic molecules cannot easily be delivered through the GI tract because of physiologic and structural barriers. We report the use of ultrasound as a modality for enhanced drug delivery to the GI tract, with an emphasis on rectal delivery. Ultrasound increased the absorption of model therapeutics inulin, hydrocortisone, and mesalamine two- to tenfold in ex vivo tissue, depending on location in the GI tract. In pigs, ultrasound induced transient cavitation with negligible heating, leading to an order of magnitude enhancement in the delivery of mesalamine, as well as successful systemic delivery of a macromolecule, insulin, with the expected hypoglycemic response. In a rodent model of chemically induced acute colitis, the addition of ultrasound to a daily mesalamine enema (compared to enema alone) resulted in superior clinical and histological scores of disease activity. In both animal models, ultrasound treatment was well tolerated and resulted in minimal tissue disruption, and in mice, there was no significant effect on histology, fecal score, or tissue inflammatory cytokine levels. The use of ultrasound to enhance GI drug delivery is safe in animals and could augment the efficacy of GI therapies and broaden the scope of agents that could be delivered locally and systemically through the GI tract for chronic conditions such as inflammatory bowel disease.

  5. Multimodal pain stimulation of the gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Asbjφrn Mohr Drewes; Hans Gregersen

    2006-01-01

    Understanding and characterization of pain and other sensory symptoms are among the most important issues in the diagnosis and assessment of patient with gastrointestinal disorders. Methods to evoke and assess experimental pain have recently developed into a new area with the possibility for multimodal stimulation (e.g.,electrical, mechanical, thermal and chemical stimulation)of different nerves and pain pathways in the human gut. Such methods mimic to a high degree the pain experienced in the clinic. Multimodal pain methods have increased our basic understanding of different peripheral receptors in the gut in health and disease. Together with advanced muscle analysis, the methods have increased our understanding of receptors sensitive to mechanical,chemical and temperature stimuli in diseases, such as systemic sclerosis and diabetes. The methods can also be used to unravel central pain mechanisms, such as those involved in allodynia, hyperalgesia and referred pain. Abnormalities in central pain mechanisms are often seen in patients with chronic gut pain and hence methods relying on multimodal pain stimulation may help to understand the symptoms in these patients.Sex differences have been observed in several diseases of the gut, and differences in central pain processing between males and females have been hypothesized using multimodal pain stimulations. Finally, multimodal methods have recently been used to gain more insight into the effect of drugs against pain in the GI tract.Hence, the multimodal methods undoubtedly represents a major step forward in the future characterization and treatment of patients with various diseases of the gut.

  6. US of the upper gastrointestinal tract

    International Nuclear Information System (INIS)

    The authors have used large-aperture, dynamically focused US imaging with the patient in an upright position in a series of cases with symptomatic upper gastrointestinal (GI) tract complaints. They found that the gastric antrum and portions of the bulb and remainder of the duodenum could be seen in each case. Scan planes tangential to the luminal surface show fold patterns, while conventional axial and transverse planes depict specific wall features, such as submucosal elevation with duodenitis, muscle layer fibrosis with chronic peptic ulcer disease, or focal subserosal hematomas. Motility patterns are evaluated with continuous imaging. The disadvantage is in limited or variable sampling. In their direct comparison of upper GI barium studies and US in these patients, there was generally diagnostic concordance, although the authors conclude that the methods are complementary since each detected individual abnormalities. Since US viewing of the upper GI tract requires only a brief increment of scanning time, they recommend that this be added routinely to each upper abdominal US study. They also urge that a US survey be an essential part of any upper GI tract study referred traditionally and selectively for a barium radiographic examination

  7. Rheumatic manifestations of pituitary tumors.

    Science.gov (United States)

    Stavrou, S; Kleinberg, D L

    2001-10-01

    Pituitary tumors may cause rheumatologic problems as a result of under production or overproduction of one pituitary hormone. Excessive growth hormone causes destruction of cartilage by a direct action. Facial and acral changes and arthralgias may be some of the first symptoms of acromegaly. The arthritis associated with acromegaly is often devastating. Carpal tunnel syndrome is very common in patients with acromegaly. Adrenocorticotropin (ACTH) has indirect effects via the action of glucocorticoid on bones, muscles, and the immune system. Proximal muscle weakness is a characteristic feature of Cushing's syndrome. Patients with Cushing's syndrome commonly have osteopenia and osteoporosis that lead to an increase in bone fractures. Avascular necrosis is associated with exogenous steroid administration. The effects of too much glucocorticoid or too rapid withdrawal can be severe. Gonadotropins act via the gonadal steroids and protect bone mass from loss. Prolactin is less involved in rheumatologic disease; the data for which are limited in humans. Pituitary tumors can have manifestations similar to rheumatologic disorders and should be included in the differential diagnosis of these diseases.

  8. Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review.

    Science.gov (United States)

    Díaz Del Arco, Cristina; Álvarez Sánchez, Ángel; Fernández Aceñero, M Jesús

    2016-09-01

    Gastrointestinal xanthomas are infrequent non-neoplastic lesions characterized by the accumulation of foam cells in the lamina propria. They are commonly seen in association with dyslipidemia, chemotherapy or radiotherapy, and infections in immunosuppressed patients. However, no clear connection to hyperlipidemia has been found. They occur more frequently in the stomach, and are very rare in the small bowel and esophagus. We identified all cases of non-gastric xanthoma or xanthomatosis reported in the English literature by searching the PubMed database and retrospectively reviewed the clinical, endoscopic, and histopathologic features of the 11 cases of non-gastric gastrointestinal xanthomas diagnosed in our hospital. Nine lesions were located in the large bowel, one in the duodenum and one in the esophagus. All xanthomas were small (<5 mm) sessile polyps except the esophageal xanthoma, which measured 13 mm. Two cases in the large bowel and the case in the small bowel were multiple. Most patients with large bowel xanthomas had hypercholesterolemia, unlike esophageal and small bowel cases. The esophageal lesion occurred in a patient with a history of partial fundoplication due to gastroesophageal reflux disease and the small bowel case was associated to chronic atrophic gastritis with intense activity. In our search of the English literature, we found 19 cases of xanthoma or xanthomatosis in the esophagus, 13 cases in the small bowel and 61 cases in the large bowel. In conclusion, gastrointestinal xanthomas, other than the gastric ones, are rare, and are usually incidental findings. PMID:27689205

  9. Anemia and iron deficiency in gastrointestinal and liver conditions.

    Science.gov (United States)

    Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

    2016-09-21

    Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice. PMID:27672287

  10. Chronic inflammatory disorders of the gastrointestinal tract of companion animals.

    Science.gov (United States)

    Cave, N J

    2003-12-01

    In the inflammatory bowel diseases (IBD) that affect dogs and cats there appears to be dysregulation of normal mucosal immunity, characterised by polyclonal lymphocytic infiltrates which are presumably specific for luminal antigens. There is an absence of a classical polarisation of either T-helper (Th) 1 or Th2 cytokine responses, although increased expression of mRNA for interleukin (IL) 2 and IL-12p40 and a shift towards mucosal immunoglobulin (Ig) G production are consistent findings, whilst variable responses are seen in tumour necrosis factor-alpha (TNF-alpha), IL-1, IL-4, IL-6, and interferon-gamma (IFN-gamma). Increased mucosal permeability and deranged intestinal motility are common sequelae. Despite obvious similarities with Crohn's disease and ulcerative colitis in humans, important differences exist. Of these, the diffuse superficial nature but with no Th1 or Th2 bias, and the prevalence of proximal small intestinal disease are notable. Potential hypotheses for these disparities include specific differences in the types or locations of agonistic gut flora, diffuse abnormalities in microbial-host interactions, a greater importance of diet, or anatomical or cellular differences in mucosal immune responses. Although specific pathogens and genetic susceptibilities may be involved, quantitative or qualitative changes in the normal flora or abnormal responses to a normal flora are more likely to be involved in the immunopathogenesis. Dietary influences include a large source of antigen, promotion of abnormal microbial growth through Maillard compounds within canned diets, and specific macro- and micronutrient deficiencies. Although dependent on a histopathological diagnosis, limitations of biopsies procured endoscopically, lack of histopathological standardisation and difficulty distinguishing inflammation from neoplasia remain significant problems. Clinician-pathologist dialogue, immunohistochemistry, cytokine profiling and lymphocyte clonality assessment may lead to more accurate diagnoses, a deeper understanding of the immunopathogenesis, and ultimately to new therapies or prevention of disease induction.

  11. Water quality as a predictor of gastrointestinal illness following incidental contact water recreation.

    Science.gov (United States)

    Dorevitch, Samuel; DeFlorio-Barker, Stephanie; Jones, Rachael M; Liu, Li

    2015-10-15

    Microbial measures of water quality are predictors of gastrointestinal illness among swimmers in some settings but not in others. Little is known whether water quality measures predict illness among people who engage in popular water recreation activities such as paddling, rowing, fishing, or boating ("incidental contact water recreation"). We sought to evaluate indicator microbes, protozoan pathogens, and turbidity as predictors of gastrointestinal illness following incidental contact water recreation. A cohort study of incidental contact water recreation was conducted in the Chicago, USA area. Recreation took place on inland lakes, rivers, Lake Michigan, and an urban waterway heavily impacted by wastewater effluent. Water samples were analyzed for Escherichia coli, enterococci, somatic coliphages, F+ coliphages, Giardia spp. and Cryptosporidium spp. (oo)cysts, and for turbidity. Median enterococci concentrations were 71.0 and 199.8 colony forming units/100  mL at general use and effluent-dominated waters, respectively. Among 4694 study participants with complete covariate data, 193 (4.1%) developed gastrointestinal illness within three days of water recreation. In multivariable logistic regression analysis, water quality metrics did not predict gastrointestinal illness among water recreators. Several variables other than water quality were associated acute gastrointestinal illness. The odds of such illness was increased by approximately two-fold by the presence of a chronic gastrointestinal condition, water exposure to the face, and by approximately 50% among those who fished (as opposed to other incidental contact activities). The odds of illness were reduced by approximately 50% among individuals who frequently used a water body for recreation. Unlike studies of swimmers at wastewater-impacted beaches that observed associations between water quality and illness incidence, this study did not. Public health protections for incidental contact recreation might

  12. Pattern of pediatric upper gastrointestinal disease: A teaching hospital experience

    Directory of Open Access Journals (Sweden)

    Lardhi A

    1996-01-01

    Full Text Available During the period 1983-1993, 166 pediatric patients(91 females and 75 males were subjected to upper gastrointestinal endoscopy. Epigastric pain or heart burn and vomiting were the indications in 115 (69 %patients. Gastritis. duodenitis, and esophagitis were diagnosed in 63 (38 %, and duodenal ulcer in seven (4.2%patients. Bleeding sites were identified in 10 out of 21 (47.6% patients with a history of hematemesis. Helicobacter pylori was identified in 12 (48% of 25 patients with chronic gastritis. Endoscopic removal of foreign bodies (FB was required in nine patients. Endoscopic small bowel biopsy provided sufficient material to con-firm the diagnosis in seven out of 13 patients with chronic diarrhea. Endoscopic findings were normal in 78 (47%patients. The procedure was safe and well tolerated.

  13. The radiological manifestation of cryptococcosis

    International Nuclear Information System (INIS)

    Cryptococcosis is an uncommon mycotic disease caused by Cryptococcosis neoformans, with a special affinity for the respiratory and central nervous system, and less frequently affecting liver, spleen, skin, lymph nodes and kidney. It was first described by Busse in 1984, and since then the occurrences had been world-widely reported with increasing incidence. The outcome of the disease may be fatal when the treatment is delayed. The main portal of entry is via the respiratory tract, and the pulmonary manifestations are not specific but quite varying, that solitary or multiple pulmonary masses, nodular or reticular infiltrations, cavity formation, lymphadenopathy or pleural effusion can be detected on the chest X-ray film simulating many other diseases. Authors analyzed and evaluated 16 cases of confirmed cryptococcosis, and interesting clinical and radiologic features that definitely differed from most of the other reports were notable as follows: 1. The incidence of cryptococcosis ranks 3rd (4.3%) among deep mycoses, next to moniliasis and aspergillosis. 2. 15 of 16 patients are in the period of pediatric age under 16 year old of age. 3. There are no remarkable underlying diseases or predisposing factors encountered in all of the 16 cases. 4. Besides the predominating meningeal irritating symptoms, the involvement of the reticuloendothelial system, l.e., lymph nodes, liver and spleen are notable. 5. Characteristic features of the pulmonary cryptococcosis are: a) 8 of 10 cases have marked hilar and paratracheal lymph nodes enlargement. b) None of the cases reveals solitary pulmonary mass, cavity formation or pleural effusion. c) The lung infiltrations are mainly reticular or coarse nodular pattern. d) The infiltrations s are diffusely distributed on entire lung field, rather than the predilection for the lower lobe. 6. Similarly to most of the other reports, the central nervous system involvement are most frequent (12 of 16 cases). 7. The combined therapy with

  14. Cystic thymic diseases: CT manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Song, Soon Young; Choi, Yo Won; Jeon, Eui Yong; Jeon, Seok Chol; Seo, Heung Suk; Hahm, Chang Kok [School of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1995-09-15

    To describe CT findings and differential points of cystic thymic lesions. We evaluated retrospectively total 19 masses with well marginated cystic lesions at thymic area on CT scans. They were 10 teratomas, 3 congenital thymic cysts, 2 multilocular thymic cysts(associated with thymoma and myasthenia gravis in each), 2 cysts Assciated with thymic Hodgkin's lymphomas an ectopic parathyroid cyst, and an infected thymic cyst. The radiological abnormalities evaluated were thickness of the wall, presence or abscene of septa, mural nodule, solid component, calcification and fat component. All three cases of congenital thymic cysts and an ectopic parathyroid cyst appeared as thin-walled unilocular cyst with homogeneous internal density and without identifiable solid component. In multilocular thymic cyst, there were thick wall and solid components(n =2), thick internal septa and calcifications(n = 1). The cysts of teratomas manifested thick walls(n = 9), internal septa(n = 4), calcifications(n = 6), fat components(n = 4), and solid components(n = 4). Cysts in Hodgkin's diseases appeared as multilocular or unilocular and had thick wall and septa without calcification. Infected thymic cyst presented with multilocular cystic mass with identifiable wall and septa, calcification, and solid components. The thymic diseases with cystic lesion include teratomas, congenital thymic cysts, multilocular thymic cysts, parathyroid cyst, and Hodgkin's disease. Congenital thymic cyst and ectopic parathyroid cyst are thin-walled unilocular cystic lesions. Cystic lesions associated with teratoma, Hodgkin's disease, and multilocular thymic cyst are thick-walled cystic lesions with or without solid component.

  15. Recurrent Renal Cell Carcinoma with Synchronous Tumor Growth in Azygoesophageal Recess and Duodenum: A Rare Cause of Anemia and Upper Gastrointestinal Bleeding

    Science.gov (United States)

    Vootla, Vamshidhar R.; Kashif, Muhammad; Niazi, Masooma; Nayudu, Suresh K.

    2015-01-01

    Renal cell carcinoma (RCC) has potential to present with distant metastasis several years after complete resection. The common sites of metastases include the lungs, bones, liver, renal fossa, and brain. RCCs metastasize rarely to the duodenum, and duodenal metastasis presenting with acute gastrointestinal bleed is infrequently reported in literature. We present a case of synchronous presentation of duodenal and azygoesophageal metastasis manifesting as acute upper gastrointestinal bleeding, four years after undergoing nephrectomy for RCC. The patient underwent further workup and was treated with radiation. The synchronous presentation is rare and stresses the importance of searching for recurrence of RCC in patients presenting with acute gastrointestinal bleeding. PMID:26640732

  16. Metastatic breast cancer to the gastrointestinal tract: A case series and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Jose Nazareno; Donald Taves; Harold G Preiksaitis

    2006-01-01

    Metastatic breast cancer involving the hepatobiliary tract or ascites secondary to peritoneal carcinomatosis has been well described. Luminal gastrointestinal tract involvement is less common and recognition of the range of possible presentations is important for early and accurate diagnosis and treatment. We report 6 patients with a variety of presentations of metastatic breast cancer of the luminal gastrointestinal tract. These include oropharyngeal and esophageal involvement presenting as dysphagia with one case of pseudoachalasia, a linitis plastica-like picture with gastric narrowing and thickened folds, small bowel obstruction and multiple strictures mimicking Crohn's disease, and a colonic neoplasm presenting with obstruction. Lobular carcinoma,representing only 10% of breast cancers is more likely to metastasize to the gastrointestinal tract. These patients presented with gastrointestinal manifestations after an average of 9.5 years and as long as 20 years from initial diagnosis of breast cancer. Given the increased survival of breast cancer patients with current therapeutic regimes, more unusual presentations of metastatic disease, including involvement of the gastrointestinal tract can be anticipated.

  17. Drug utilization of clarithromycin for gastrointestinal disease treatment

    Institute of Scientific and Technical Information of China (English)

    Quan Zhou; Ling-Ling Zhu; Xiao-Feng Yan; Wen-Sheng Pan; Su Zeng

    2008-01-01

    AIM: To evaluate the patterns of use of clarithromycin for gastrointestinal disease treatment and promote its rational use.METHODS: Using a structured pro forma, we conducted a two-month survey of the electronic prescriptions containing immediate-release (IR) or sustained-release (SR) product of clarithromycin for outpatients with gastrointestinal diseases in a 2200-bed general hospital. Suitability of the prescription was audited retrospectively.RESULTS: One hundred and sixty-four prescriptions of SR product and 110 prescriptions of IR product were prescribed for gastrointestinal disease treatment. Among prescriptions for anti-Helicobacter pylori(H pylori) therapy, triple therapy take the dominant position (91.8%), followed by quadruple therapy (4.3%) and dual therapy (3.9%). Amoxicillin was the most frequently co-prescribed antibiotic. Furazolidone and levofloxacin are used more widely than metronidazole or tinidazole. Clarithromycin SR was administered at inappropriate time points in all prescriptions. Fifty percent of all prescriptions of clarithromycin SR, and 6.4% of prescriptions of clarithromycin IR, were prescribed at inappropriate dosing intervals. Surprisingly, disconcordance between diagnoses and indications was observed in all prescriptions of clarithromycin SR which has not been approved for treating Hpylori infection although off-label use for this purpose was reported in literature. On the contrary, only one prescription (0.9%) of clarithromycin IR was prescribed for unapproved indication (i.e. Gastro-oesophageal reflux disease). 1.4% of prescriptions for chronic gastritis or peptic ulcer treatment were irrational in that clarithromycin was not co-prescribed with gastric acid inhibitors. Clinical significant CYP3A based drug interactions with clarithromycin were identified.CONCLUSION: There is a great scope to improve the quality of clarithromycin prescribing in patients with gastrointestinal disease, especially with regard to administration

  18. Tissue Staining (Chromoscopy) of the Gastrointestinal Tract

    OpenAIRE

    Fennerty, M. Brian

    1999-01-01

    Tissue staining, or chomoscopy, is used as an adjunctive technique during gastrointestinal endoscopy. Chemical agents are applied to the gastrointestinal mucosal surface to identify specific epithelia or to enhance the mucosal surface characteristics of the gastrointestinal epithelium. This aids in the recognition of subtle lesions (ie, polyps) or allows directed targeting of biopsies (ie, sprue or Barrett’s esophagus) to increase the yield of endoscopic diagnostic accuracy. The four endoscop...

  19. Extra-articular manifestations of rheumatoid arthritis: An update.

    Science.gov (United States)

    Prete, Marcella; Racanelli, Vito; Digiglio, Liboria; Vacca, Angelo; Dammacco, Franco; Perosa, Federico

    2011-12-01

    Rheumatoid arthritis (RA) is an immune-mediated disease involving chronic low-grade inflammation that may progressively lead to joint destruction, deformity, disability and even death. Despite its predominant osteoarticular and periarticular manifestations, RA is a systemic disease often associated with cutaneous and organ-specific extra-articular manifestations (EAM). Despite the fact that EAM have been studied in numerous RA cohorts, there is no uniformity in their definition or classification. This paper reviews current knowledge about EAM in terms of frequency, clinical aspects and current therapeutic approaches. In an initial attempt at a classification, we separated EAM from RA co-morbidities and from general, constitutional manifestations of systemic inflammation. Moreover, we distinguished EAM into cutaneous and visceral forms, both severe and not severe. In aggregated data from 12 large RA cohorts, patients with EAM, especially the severe forms, were found to have greater co-morbidity and mortality than patients without EAM. Understanding the complexity of EAM and their management remains a challenge for clinicians, especially since the effectiveness of drug therapy on EAM has not been systematically evaluated in randomized clinical trials. PMID:21939785

  20. Kronisk pancreatitis og øvre gastrointestinal blødning

    DEFF Research Database (Denmark)

    Larsen, H C; Bak, Martin

    1995-01-01

    A 46 year-old woman with a history of chronic pancreatitis, upper epigastric pain and upper gastrointestinal bleeding of obscure origin is presented. A haemoductal pancreatitis was the source of bleeding due to erosion of the splenic artery with bleeding into a pancreatic pseudocyst communicating...... with the pancreatic duct. This case was special, because there was no aneurysmal dilatation of the splenic artery. This rare entity must always be considered in the diagnosis of gastrointestinal haemorrhage of obscure origin. The appropriate investigation to confirm the diagnosis is visceral angiography, if necessary...

  1. Gastrointestinal helminths in migratory Camel

    Directory of Open Access Journals (Sweden)

    S G Rewatkar

    Full Text Available Survey of gastrointestinal helminth parasites in camel migrated from U.P., M.P., and Rajasthan at Nagpur region was carried out in early summer, 2008. Total 28 samples (12 males and 16 females were collected from different places of Nagpur region. They revealed parasites as Trichuris sp.(50%, Strongyloides sp.(32.14%, Trichostrongylus sp.(10.71%, Nematodirus sp.(10.71%, Haemonchus sp.(14.28%, Eurytrema sp.(21.42% ,Eimeria sp.(25%, Entamoeba sp.(17.85% and Balantidium sp.(7.14%.All were found positive for mixed helminthic infection. [Vet World 2009; 2(7.000: 258-258

  2. Multicentric malignant gastrointestinal stromal tumor

    OpenAIRE

    Shukla Shailaja; Singh Sanjeet; Pujani Mukta

    2009-01-01

    Malignant gastrointestinal stromal tumor (GIST) is a rare type of sarcoma that is found in the digestive system, most often in the wall of the stomach. Multiple GISTs are extremely rare and usually associated with type 1 neurofibromatosis and familial GIST. We report here a case of a 70-year-old woman who reported pain in the abdomen, loss of appetite, and weight loss for six months. Ultrasound examination showed a small bowel mass along with multiple peritoneal deposits and a mass within th...

  3. Changes to the gastrointestinal tract.

    Science.gov (United States)

    2016-08-01

    This article explores changes in the ageing gastrointestinal tract, including: » Diminished sense of taste and smell. » Shrinking of the maxillary and mandibular bones in the jaw. » Slowing of oesophageal peristalsis giving a feeling that something is 'stuck in the throat'. » Relaxation of the lower sphincter leading to gastro-oesophageal reflux. » Reduction in gastric bicarbonate and prostaglandin in mucus increasing susceptibility to stomach ulcers. » Changes in villi in the small intestine reducing the area for absorption. » Overpopulation of bacteria in the small intestine leading to decreased absorption of folic acid and minerals. PMID:27573953

  4. Congenital rubella syndrome and delayed manifestations

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2010-01-01

    Objective: Several hypotheses of different medical and psychological delayed manifestations among people who have congenital rubella syndrome (CRS) have been discussed. This study tests some of these hypotheses of delayed manifestations. Methods: Gathering information about 35 individuals who have...

  5. Oral manifestations of syphilis: a review

    Directory of Open Access Journals (Sweden)

    A.B. Soares

    2004-01-01

    Full Text Available Syphilis is an infectious disease presenting stages associated with specific oral lesions. Therefore, health professionals should be familiar with the different syphilis oral manifestations at each stage and be prepared to refer any suspected patient for further evaluation. This report describes the most important clinical factors of each stage, emphasizing the oral manifestations.

  6. 19 CFR 123.32 - Manifests.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Manifests. 123.32 Section 123.32 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through the United States § 123.32 Manifests. (a) Form and number of copies required....

  7. Cardiac manifestations of inborn errors of metabolism.

    NARCIS (Netherlands)

    Evangeliou, A.; Papadopoulou-Legbelou, K.; Daphnis, E.; Ganotakis, E.; Vavouranakis, I.; Michailidou, H.; Hitoglou-Makedou, A.; Nicolaidou, P.; Wevers, R.A.; Varlamis, G.

    2007-01-01

    AIM: The aim of the study was to investigate the frequency and type of cardiac manifestations in a defined group of patients with inborn errors of metabolism. This paper also explores the key role of cardiac manifestations in the diagnosis of inborn errors of metabolism in daily practice. METHODS: O

  8. [Hemolytic uremic syndrome. Clinical manifestations. Treatment].

    Science.gov (United States)

    Exeni, Ramón A

    2006-01-01

    Clinical manifestation are described in children with epidemic HUS. The intestinal involvement in the prodromic period, is outlined and the most common disturbances such acute renal failure, thrombocytopenia, hemolytic anemia, leucocitosis hypertension, neurological, pancreatic and cardiac manifestations are described. We discuss the acid-base and electrolyte disturbances, metabolic acidosis, hyponatremia, hyperkalemia. The etiopathogenic treatment and the control of renal sequelae are also discussed.

  9. Abdominal manifestations of autoimmune disorders

    International Nuclear Information System (INIS)

    Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking

  10. Review of the diagnosis and management of gastrointestinal bezoars.

    Science.gov (United States)

    Iwamuro, Masaya; Okada, Hiroyuki; Matsueda, Kazuhiro; Inaba, Tomoki; Kusumoto, Chiaki; Imagawa, Atsushi; Yamamoto, Kazuhide

    2015-04-16

    The formation of a bezoar is a relatively infrequent disorder that affects the gastrointestinal system. Bezoars are mainly classified into four types depending on the material constituting the indigestible mass of the bezoar: phytobezoars, trichobezoars, pharmacobezoars, and lactobezoars. Gastric bezoars often cause ulcerative lesions in the stomach and subsequent bleeding, whereas small intestinal bezoars present with small bowel obstruction and ileus. A number of articles have emphasized the usefulness of Coca-Cola(®) administration for the dissolution of phytobezoars. However, persimmon phytobezoars may be resistant to such dissolution treatment because of their harder consistency compared to other types of phytobezoars. Better understanding of the etiology and epidemiology of each type of bezoar will facilitate prompt diagnosis and management. Here we provide an overview of the prevalence, classification, predisposing factors, and manifestations of bezoars. Diagnosis and management strategies are also discussed, reviewing mainly our own case series. Recent progress in basic research regarding persimmon phytobezoars is also briefly reviewed. PMID:25901212

  11. Review of the diagnosis and management of gastrointestinal bezoars.

    Science.gov (United States)

    Iwamuro, Masaya; Okada, Hiroyuki; Matsueda, Kazuhiro; Inaba, Tomoki; Kusumoto, Chiaki; Imagawa, Atsushi; Yamamoto, Kazuhide

    2015-04-16

    The formation of a bezoar is a relatively infrequent disorder that affects the gastrointestinal system. Bezoars are mainly classified into four types depending on the material constituting the indigestible mass of the bezoar: phytobezoars, trichobezoars, pharmacobezoars, and lactobezoars. Gastric bezoars often cause ulcerative lesions in the stomach and subsequent bleeding, whereas small intestinal bezoars present with small bowel obstruction and ileus. A number of articles have emphasized the usefulness of Coca-Cola(®) administration for the dissolution of phytobezoars. However, persimmon phytobezoars may be resistant to such dissolution treatment because of their harder consistency compared to other types of phytobezoars. Better understanding of the etiology and epidemiology of each type of bezoar will facilitate prompt diagnosis and management. Here we provide an overview of the prevalence, classification, predisposing factors, and manifestations of bezoars. Diagnosis and management strategies are also discussed, reviewing mainly our own case series. Recent progress in basic research regarding persimmon phytobezoars is also briefly reviewed.

  12. Acute syndrome of radiation: injuries to the gastrointestinal tract; Syndrome aigu d'irradiation: les atteintes du systeme gastro-intestinal

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, N.M.; Dublineau, I.; Lebrun, F.; Linard, C.; Monti, P.; Picard, C.; Scanff, P.; Aigueperse, J. [CEA Fontenay-aux-Roses, 92 (France). Inst. de Radioprotection et de Surete Nucleaire

    2002-06-01

    Acute syndrome of radiation: injuries to the gastrointestinal tract. Exposure to ionising radiation at medium to high doses results in the manifestation of mixed pathologies. Following the analysis of several radiation accidents it is clear that intestinal injury influences patient survival. However the appearance of the classically defined gastrointestinal syndrome is not always evident. Nevertheless injury to the gastrointestinal tract, in particular loss of barrier function, seems to play an important role in the development of Multiple Organ Failure such as reported in the recent accident at Tokai Mura. Ionising radiation overexposure results in changes in intestinal motility and nutrient, fluid and electrolyte absorption and secretion all which may contribute to the genesis of diarrhea. In addition to modified cellular transport properties for nutrients or electrolytes, important loss of epithelial cells is also a major contributing factor. Intestinal functions are controlled by many factors such as neurotransmitters, locally released mediators from endocrine cells or immunocompetent cells in addition to luminal agents. To date, treatment of radiation-induced gastrointestinal injury is mainly symptomatic. However treatments such as growth factors, anti-inflammatory cytokines as well as cellular transplantation remain to be validated in the radiation accident situation. (author)

  13. Gastrointestinal citrate absorption in nephrolithiasis

    Science.gov (United States)

    Fegan, J.; Khan, R.; Poindexter, J.; Pak, C. Y.

    1992-01-01

    Gastrointestinal absorption of citrate was measured in stone patients with idiopathic hypocitraturia to determine if citrate malabsorption could account for low urinary citrate. Citrate absorption was measured directly from recovery of orally administered potassium citrate (40 mEq.) in the intestinal lavage fluid, using an intestinal washout technique. In 7 stone patients citrate absorption, serum citrate levels, peak citrate concentration in serum and area under the curve were not significantly different from those of 7 normal subjects. Citrate absorption was rapid and efficient in both groups, with 96 to 98% absorbed within 3 hours. The absorption of citrate was less efficient from a tablet preparation of potassium citrate than from a liquid preparation, probably due to a delayed release of citrate from wax matrix. However, citrate absorption from solid potassium citrate was still high at 91%, compared to 98% for a liquid preparation. Thus, hypocitraturia is unlikely to be due to an impaired gastrointestinal absorption of citrate in stone patients without overt bowel disease.

  14. Does Hypothyroidism Affect Gastrointestinal Motility?

    Directory of Open Access Journals (Sweden)

    Olga Yaylali

    2009-01-01

    Full Text Available Background. Gastrointestinal motility and serum thyroid hormone levels are closely related. Our aim was to analyze whether there is a disorder in esophagogastric motor functions as a result of hypothyroidism. Materials and Methods. The study group included 30 females (mean age ± SE 45.17 ± 2.07 years with primary hypothyroidism and 10 healthy females (mean age ± SE 39.40 ± 3.95 years. All cases underwent esophagogastric endoscopy and scintigraphy. For esophageal scintigraphy, dynamic imaging of esophagus motility protocol, and for gastric emptying scintigraphy, anterior static gastric images were acquired. Results. The mean esophageal transit time (52.56 ± 4.07 sec for patients; 24.30 ± 5.88 sec for controls; P=.02 and gastric emptying time (49.06 ± 4.29 min for the hypothyroid group; 30.4 ± 4.74 min for the control group; P=.01 were markedly increased in cases of hypothyroidism. Conclusion. Hypothyroidism prominently reduces esophageal and gastric motor activity and can cause gastrointestinal dysfunction.

  15. Unusual manifestations of acute Q fever: autoimmune hemolytic anemia and tubulointerstitial nephritis

    Directory of Open Access Journals (Sweden)

    Korkmaz Serdal

    2012-05-01

    Full Text Available Abstract Q fever is a worldwide zoonotic infection that caused by Coxiella burnetii, a strict intracellular bacterium. It may be manifested by some of the autoimmune events and is classified into acute and chronic forms. The most frequent clinical manifestation of acute form is a self-limited febrile illness which is associated with severe headache, muscle ache, arthralgia and cough. Meningoencephalitis, thyroiditis, pericarditis, myocarditis, mesenteric lymphadenopathy, hemolytic anemia, and nephritis are rare manifestations. Here we present a case of acute Q fever together with Coombs’ positive autoimmune hemolytic anemia (AIHA and tubulointerstitial nephritis treated with chlarithromycin, steroids and hemodialysis. Clinicians should be aware of such rare manifestations of the disease.

  16. Abnormal Liver Function Tests in an Anorexia Nervosa Patient and an Atypical Manifestation of Refeeding Syndrome.

    Science.gov (United States)

    Vootla, Vamshidhar R; Daniel, Myrta

    2015-01-01

    Refeeding syndrome is defined as electrolyte and fluid abnormalities that occur in significantly malnourished patients when they are refed orally, enterally, or parenterally. The principal manifestations include hypophosphatemia, hypokalemia, vitamin deficiencies, volume overload and edema. This can affect multiple organ systems, such as the cardiovascular, pulmonary, or neurological systems, secondary to the above-mentioned abnormalities. Rarely, patients may develop gastrointestinal symptoms and show abnormal liver function test results. We report the case of a 52-year-old woman with anorexia nervosa who developed refeeding syndrome and simultaneous elevations of liver function test results, which normalized upon the resolution of the refeeding syndrome.

  17. Abnormal Liver Function Tests in an Anorexia Nervosa Patient and an Atypical Manifestation of Refeeding Syndrome

    Directory of Open Access Journals (Sweden)

    Vamshidhar R. Vootla

    2015-07-01

    Full Text Available Refeeding syndrome is defined as electrolyte and fluid abnormalities that occur in significantly malnourished patients when they are refed orally, enterally, or parenterally. The principal manifestations include hypophosphatemia, hypokalemia, vitamin deficiencies, volume overload and edema. This can affect multiple organ systems, such as the cardiovascular, pulmonary, or neurological systems, secondary to the above-mentioned abnormalities. Rarely, patients may develop gastrointestinal symptoms and show abnormal liver function test results. We report the case of a 52-year-old woman with anorexia nervosa who developed refeeding syndrome and simultaneous elevations of liver function test results, which normalized upon the resolution of the refeeding syndrome.

  18. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  19. Carbonic anhydrases in normal gastrointestinal tract and gastrointestinal tumours

    Institute of Scientific and Technical Information of China (English)

    Antti J. Kivel(a); Jyrki Kivel(a); Juha Saarnio; Seppo Parkkila

    2005-01-01

    Carbonic anhydrases (CAs) catalyse the hydration of CO2to bicarbonate at physiological pH. This chemical interconversion is crucial since HCO3- is the substrate for several biosynthetic reactions. This review is focused on the distribution and role of CA isoenzymes in both normal and pathological gastrointestinal (GI) tract tissues. It has been known for many years that CAs are widely present in the GI tract and play important roles in several physiological functions such as production of saliva, gastric acid, bile, and pancreatic juice as well as in absorption of salt and water in intestine. New information suggests that these enzymes participate in several processes that were not envisioned earlier. Especially, the recent reports on plasma membranebound isoenzymes Ⅸ and Ⅻ have raised considerable interest since they were reported to participate in cancer invasion and spread. They are induced by tumour hypoxia and may also play a role in von Hippel-Lindau (VHL)-mediated carcinogenesis.

  20. Possible Waardenburg syndrome with gastrointestinal anomalies.

    OpenAIRE

    Nutman, J; Steinherz, R; Sivan, Y; Goodman, R M

    1986-01-01

    We describe a patient with possible Waardenburg syndrome associated with anal atresia and oesophageal atresia with tracheooesophageal fistula. Three other published cases with atretic gastrointestinal anomalies associated with the Waardenburg syndrome are reviewed. We conclude that the association between atretic lesions of the gastrointestinal tract and the Waardenburg syndrome may be a significant one.

  1. Upper gastrointestinal hemorrhage caused by superwarfarin poisoning

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Superwarfarins are a class of rodenticides. Gastrointestinal hemorrhage is a fatal complication of superwarfarin poisoning, requiring immediate treatment. Here, we report a 55-year-old woman with tardive upper gastrointestinal hemorrhage caused by superwarfarin poisoning after endoscopic cold mucosal biopsy.

  2. Stress, Anxiety and Functional Gastrointestinal Disorders

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2012-04-01

    Full Text Available Stress has major role in functional gastrointestinal system disorders. The most typical example of this situation is Irritable bowel syndrome. Gastrointestinal system’s response to acute or short-term of stress is delay of gastric emptying and stimulation of colonic transition. While CRF2 receptors are mediate the upper section inhibition, CRF1 is responsible for the lower part colonic and anxiogenic response. Visceral hypersensitivity is managed by the emotional motor system, the amygdala plays a significant role and mucosal mast cells arise. But in people with symptoms of functional gastrointestinal, how is differ motility response in healthy individuals, this situation is due to lack of autonomous nervous system or an increased sensitivity of stress is not adequately understood. The brain-gastrointestinal axis frequency and severity of symptoms associated with negative emotions. American Gastroenterology Association is closely associated with the quality of life and is very difficult to treat the symptoms of gastrointestinal disorders, re-interpreted under the heading of 'Gastrointestinal Distress'. This review is defined as gastrointestinal distresses, physical, emotional, and behavioral components as a disorder in which, almost like an anxiety disorder are discussed. Physical component is pain, gas, and defecation problems, cognitive component is external foci control, catastrophization and anticipatory anxiety, the emotional component is somatic anxiety, hypervigilance, and avoidance of gastrointestinal stimuli as defined. [Archives Medical Review Journal 2012; 21(2.000: 122-133

  3. Gastrointestinal symptoms and ethanol metabolism in alcoholics.

    NARCIS (Netherlands)

    Laheij, R.J.F.; Verlaan, M.; Oijen, M.G.H. van; Doelder, M.S. de; Jong, C.A.J. de; Jansen, J.B.M.J.

    2004-01-01

    Excessive alcohol intake frequently results in gastrointestinal discomfort. It is an empirical fact that the severity of gastrointestinal discomfort induced by alcohol abuse is subject to interindividual variation. The aim of this study was to determine whether genetic polymorphism in alcohol dehydr

  4. The Nervous System and Gastrointestinal Function

    Science.gov (United States)

    Altaf, Muhammad A.; Sood, Manu R.

    2008-01-01

    The enteric nervous system is an integrative brain with collection of neurons in the gastrointestinal tract which is capable of functioning independently of the central nervous system (CNS). The enteric nervous system modulates motility, secretions, microcirculation, immune and inflammatory responses of the gastrointestinal tract. Dysphagia,…

  5. Peptide Hormones in the Gastrointestinal Tract

    DEFF Research Database (Denmark)

    Rehfeld, Jens F.

    2015-01-01

    Gastrointestinal hormones are peptides released from endocrine cells and neurons in the digestive tract. More than 30 hormone genes are currently known to be expressed in the gastrointestinal tract, which makes the gut the largest hormone-producing organ in the body. Modern biology makes it feasi...

  6. Neurological Manifestations In Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    youssef HNACH

    2015-06-01

    Full Text Available IntroductionThe purpose of this retrospective study was to report neurological manifestations noted in patients who were monitored for inflammatory bowel disease, in order to document the pathophysiological, clinical, progressive, and therapeutic characteristics of this entity.Material and methodsWe conducted a retrospective study on patients monitored -in the gastroenterology service in Ibn Sina Hospital in Rabat, Morocco- for inflammatory bowel disease from 1992 till 2013 and who developed neurological manifestations during its course. Patients with iatrogenic complications were excluded, as well as patients with cerebrovascular risk factors.ResultsThere were 6 patients, 4 of whom have developed peripheral manifestations. Electromyography enabled the diagnosis to be made and the outcome was favorable with disappearance of clinical manifestations and normalization of the electromyography.The other 2 patients, monitored for Crohn’s disease, developed ischemic stroke. Cerebral computed tomography angiography provided positive and topographic diagnosis. Two patients were admitted to specialized facilities.ConclusionNeurological manifestations in inflammatory bowel disease are rarely reported.  Peripheral neuropathies and stroke remain the most common manifestations. The mechanisms of these manifestations are not clearly defined yet. Currently, we hypothesize the interaction of immune mediators.

  7. Endocrine-Manifestations of Cirrhosis and Liver Disease

    Directory of Open Access Journals (Sweden)

    M Khalili

    2014-04-01

    Full Text Available The liver is involved in the synthesis and metabolism of many kinds of hormones, various abnormalities hormone levels are found in advanced liver disease. For example the liver is, extremely sensitive to changes in insulin or glucagon levels. The liver is the primary organ of iron storage is frequently involved, diabetes is common in patients with iron overload and may be seen in cirrhosis. Chronic infection with HCV is associated with insulin resistance. Thyroid disease often accompanies chronic hepatitis C infection .Anti thyroid autoantibodies are also found in chronic HCV infection. Nonalcoholic liver disease (NAFLDas a most common cause of chronic liver disease in western world ,as well accompanied by Type 2 diabetes and hyperlipidemia. Hypopituitarism and hypothyroidism also have been in NAFLD.The patients with NAFLD and Hypopituitarism may be susceptible to central obesity, dyslipidemia and insulin resistance leading to disease progression. Hepatic cirrhosis as the end stage of chronic liver disease is also associated with hypogonadism and signs of feminization. The peripheral metabolism of steroids is altered in many of hypogonadism, low testosterone level decreased libido, infertility, reduced secondary sex hair and gynecomastia, reduced spermatogenesis and peritubular fibrosis are found in men with cirrhosis .The normal function of the hypothalamic-pituitary gonadal axis is affected in liver disease. In cirrhotic patients the estrogen/androgen ratio is usually increased, the level of testosterone and dihydroepiandosteron are reduced while the estradiol level are normal or slightly elevated, these alterations are dependent on the severity of the liver disease.Succsesfull orthotropic liver transplantation  leads to improvement of the sex hormone disturbances. The pathogenesis of gynecomastia is due to the loss of equilibrium between estrogen and androgen caused by a feminizing state but it is due to increased estrogen precursor in

  8. Prevalence and factors associated with behavioral disorders in children with chronic health conditions

    Directory of Open Access Journals (Sweden)

    Budi Santoso Adji

    2010-03-01

    Conclusions Prevalence of behavioral disorders in children with chronic health condition is 37.5%. The duration of illness contributes to the manifestation of behavioral disorders in children with chronic health conditions. [Paediatr Indones. 2010;50:1-5].

  9. Antioxidant supplements for preventing gastrointestinal cancers

    DEFF Research Database (Denmark)

    Bjelakovic, G.; Nikolova, D.; Simonetti, R.G.;

    2008-01-01

    BACKGROUND: Oxidative stress may cause gastrointestinal cancers. The evidence on whether antioxidant supplements are effective in preventing gastrointestinal cancers is contradictory. OBJECTIVES: To assess the beneficial and harmful effects of antioxidant supplements in preventing gastrointestinal...... Database from inception to October 2007. We scanned reference lists and contacted pharmaceutical companies. SELECTION CRITERIA: Randomised trials comparing antioxidant supplements to placebo/no intervention examining occurrence of gastrointestinal cancers. DATA COLLECTION AND ANALYSIS: Two authors (GB...... high. Heterogeneity was low to moderate. Antioxidant supplements were without significant effects on gastrointestinal cancers (RR 0.94, 95% CI 0.83 to 1.06). However, there was significant heterogeneity (I(2) = 54.0%, P = 0.003). The heterogeneity may have been explained by bias risk (low-bias risk...

  10. Genetic alterations in syndromes with oral manifestations

    Directory of Open Access Journals (Sweden)

    Krishnamurthy Anuthama

    2013-01-01

    Full Text Available Ever since Gregor Johan Mendel proposed the law of inheritance, genetics has transcended the field of health and has entered all walks of life in its application. Thus, the gene is the pivoting factor for all happenings revolving around it. Knowledge of gene mapping in various diseases would be a valuable tool in prenatally diagnosing the condition and averting the future disability and stigma for the posterity. This article includes an array of genetically determined conditions in patients seen at our college out-patient department with complete manifestation, partial manifestation and array of manifestations not fitting into a particular syndrome.

  11. Echocardiographic manifestation of hiatus hernia simulating a left atrial mass: Case report

    Directory of Open Access Journals (Sweden)

    Oikonomou Kostas

    2008-09-01

    Full Text Available Abstract Background Despite the high prevalence of hiatus hernia, a relatively small number of echocardiographically manifested cases have been reported. Case Presentation An 82-year old woman presented with acute retrosternal pain indicative of cardiac etiology. Physical examination and biochemical tests, as well as 12-lead electrocardiogram, were normal. A two-dimensional transthoracic echocardiogram was performed and revealed a structure that was considered to represent a left atrial mass. A subsequent computed tomography scan visualized a hiatus hernia in the posterior mediastinum, impinging on the posterior left atrial wall. The intrathoracic displacement of a large part of the stomach was further confirmed by an upper gastrointestinal barium examination. Conclusion Hiatus hernia can present as acute chest pain, while its echocardiographic manifestation may resemble a left atrial space-occupying structure. Physicians should be aware of the clinical and sonographic findings to facilitate the differential diagnosis from similarly presenting cardiac entities.

  12. Sensory testing of the human gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Christina Brock; Lars Arendt-Nielsen; Oliver Wilder-Smith; Asbjφrn Mohr Drewes

    2009-01-01

    The objective of this appraisal is to shed light on the various approaches to screen sensory information in the human gut. Understanding and characterization of sensory symptoms in gastrointestinal disorders is poor. Experimental methods allowing the investigator to control stimulus intensity and modality, as well as using validated methods for assessing sensory response have contributed to the understanding of pain mechanisms. Mechanical stimulation based on impedance planimetry allows direct recordings of luminal cross-sectional areas, and combined with ultrasound and magnetic resonance imaging, the contribution of different gut layers can be estimated. Electrical stimulation depolarizes free nerve endings non-selectively. Consequently, the stimulation paradigm (single, train, tetanic) influences the involved sensory nerves. Visual controlled electrical stimulation combines the probes with an endoscopic approach, which allows the investigator to inspect and obtain small biopsies from the stimulation site. Thermal stimulation (cold or warm) activates selectively mucosal receptors, and chemical substances such as acid and capsaicin (either alone or in combination) are used to evoke pain and sensitization. The possibility of multimodal (e.g. mechanical, electrical, thermal and chemical) stimulation in different gut segments has developed visceral pain research. The major advantage is involvement of distinctive receptors, various sensory nerves and different pain pathways mimicking clinical pain that favors investigation of central pain mechanisms involved in allodynia, hyperalgesia and referred pain. As impairment of descending control mechanisms partly underlies the pathogenesis in chronic pain, a cold pressor test that indirectly stimulates such control mechanisms can be added. Hence, the methods undoubtedly represent a major step forward in the future characterization and treatment of patients with various diseases of the gut, which provides knowledge to

  13. Skin manifestations of endocrine and neuroendocrine tumors.

    Science.gov (United States)

    Leventhal, Jonathan S; Braverman, Irwin M

    2016-06-01

    The skin signs of benign and malignant endocrine and neuroendocrine tumors are manifold and early identification of these dermatologic features is crucial in initiating timely diagnosis and management. This article reviews the salient cutaneous features of these tumors that arise in the classic endocrine glands, lung and gastrointestinal tract either as individual neoplasms or as part of a syndrome.

  14. Treatment of gastrointestinal autonomic neuropathy.

    Science.gov (United States)

    Törnblom, Hans

    2016-03-01

    The symptoms caused by gastrointestinal autonomic neuropathy in diabetes mellitus is important to highlight since it affects a large proportion of people with diabetes, regardless of whether this is type 1 or type 2. Gastroparesis and general signs of bowel dysfunction, such as constipation, diarrhoea and abdominal pain are most often encountered and involve both pharmacological and non-pharmacological treatment options. This mini-review summarises a presentation given at the 'Diagnosis and treatment of autonomic diabetic neuropathy in the gut' symposium at the 2015 annual meeting of the EASD. It is accompanied by another mini-review on a topic from this symposium (by Azpiroz and Malagelada, DOI: 10.1007/s00125-015-3831-1 ) and a commentary by the Session Chair, Péter Kempler (DOI: 10.1007/s00125-015-3826-y ). PMID:26634570

  15. Neuropathophysiology of functional gastrointestinal disorders

    Institute of Scientific and Technical Information of China (English)

    Jackie D Wood

    2007-01-01

    The investigative evidence and emerging concepts in neurogastroenterology implicate dysfunctions at the levels of the enteric and central nervous systems as underlying causes of the prominent symptoms of many of the functional gastrointestinal disorders.Neurogastroenterological research aims for improved understanding of the physiology and pathophysiology of the digestive subsystems from which the arrays of functional symptoms emerge. The key subsystems for defecation-related symptoms and visceral hypersensitivity are the intestinal secretory glands, the musculature and the nervous system that controls and integrates their activity. Abdominal pain and discomfort arising from these systems adds the dimension of sensory neurophysiology. This review details current concepts for the underlying pathophysiology in terms of the physiology of intestinal secretion, motility, nervous control, sensing function, immuno-neural communication and the brain-gut axis.

  16. Hydrophysical manifestations of the Indian ocean tsunami

    Digital Repository Service at National Institute of Oceanography (India)

    Sadhuram, Y.; Murthy, T.V.R.; Rao, B.P.

    described in detail by several authors. This chapter summarises the results of our investigations on the hydrophysical manifestations (salinity and temperature, coastal currents, internal waves, etc.) of the tsunami on the coastal environments in India...

  17. Mucocutaneous manifestations of helminth infections: Nematodes.

    Science.gov (United States)

    Lupi, Omar; Downing, Christopher; Lee, Michael; Pino, Livia; Bravo, Francisco; Giglio, Patricia; Sethi, Aisha; Klaus, Sidney; Sangueza, Omar P; Fuller, Claire; Mendoza, Natalia; Ladizinski, Barry; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased globalization through international travel for business, medical volunteerism, pleasure, and immigration/refugees into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on the cutaneous manifestations of helminth infections and is divided into 2 parts: part I focuses on nematode infections, and part II focuses on trematode and cestode infections. This review highlights the clinical manifestations, transmission, diagnosis, and treatment of helminth infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus.

  18. Manifest toob klassika taas kinoekraanile / Andri Maimets

    Index Scriptorium Estoniae

    Maimets, Andri, 1979-

    2007-01-01

    2.-9. veebr. on kinos "Sõprus" ja 11.-15. veebr. Tartu Sadamateatris 5. kultusfilmide festival Manifest, seekord USA filmid ja teemaks sõnavabadus. Esilinastub ka Urmas E. Liivi dokumentaalfilm "Tervitusi Nõukogude Eestist!"

  19. Ophthalmological manifestations in segmental neurofibromatosis type 1

    OpenAIRE

    Ruggieri, M; Pavone, P; Polizzi, A; Pietro, M Di; Scuderi, A; A GABRIELE; Spalice, A; IANNETTI, P

    2004-01-01

    Aims: To study the ophthalmological manifestations in individuals with the typical features of neurofibromatosis type 1 (NF1) circumscribed to one or more body segments, usually referred to as segmental NF1.

  20. Mucocutaneous manifestations of helminth infections: Nematodes.

    Science.gov (United States)

    Lupi, Omar; Downing, Christopher; Lee, Michael; Pino, Livia; Bravo, Francisco; Giglio, Patricia; Sethi, Aisha; Klaus, Sidney; Sangueza, Omar P; Fuller, Claire; Mendoza, Natalia; Ladizinski, Barry; Woc-Colburn, Laila; Tyring, Stephen K

    2015-12-01

    In the 21st century, despite increased globalization through international travel for business, medical volunteerism, pleasure, and immigration/refugees into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on the cutaneous manifestations of helminth infections and is divided into 2 parts: part I focuses on nematode infections, and part II focuses on trematode and cestode infections. This review highlights the clinical manifestations, transmission, diagnosis, and treatment of helminth infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus. PMID:26568337

  1. Diabetic encephalopathy: Pathogenesis, clinical manifestations, therapy approaches

    Directory of Open Access Journals (Sweden)

    I. Kh. Khairullin

    2014-07-01

    Full Text Available The paper considers the epidemiology, morphology, and clinical manifestations of diabetic encephalopathy. It shows the differences of diabetic encephalopathy in types 1 and 2 diabetes mellitus. Pathogenetic treatment options for diabetic encephalopathy are given.

  2. Diabetic encephalopathy: Pathogenesis, clinical manifestations, therapy approaches

    OpenAIRE

    I. Kh. Khairullin; S. T. Zyangirova; Yu. N. Isayeva; O. R. Esin

    2014-01-01

    The paper considers the epidemiology, morphology, and clinical manifestations of diabetic encephalopathy. It shows the differences of diabetic encephalopathy in types 1 and 2 diabetes mellitus. Pathogenetic treatment options for diabetic encephalopathy are given.

  3. Diabetic encephalopathy: Pathogenesis, clinical manifestations, therapy approaches

    Directory of Open Access Journals (Sweden)

    I. Kh. Khairullin

    2012-01-01

    Full Text Available The paper considers the epidemiology, morphology, and clinical manifestations of diabetic encephalopathy. It shows the differences of diabetic encephalopathy in types 1 and 2 diabetes mellitus. Pathogenetic treatment options for diabetic encephalopathy are given.

  4. Clinical Manifestations and Diagnosis of Acromegaly

    OpenAIRE

    Gloria Lugo; Lara Pena; Fernando Cordido

    2012-01-01

    Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Ac...

  5. Neurologic Manifestations of Childhood Rheumatic Diseases

    OpenAIRE

    Shiari, Reza

    2012-01-01

    How to Cite this Article: Shiari R. Neurologic Manifestations of Childhood Rheumatic Diseases.  Iran J Child Neurol Autumn 2012; 6(4): 1-7.Children with rheumatic disorders may have a wide variety of clinical features ranging from fever or a simple arthritis to complex multisystem autoimmune diseases. Information about the prevalence of neurological manifestations in children with rheumatologic disorders is limited. This review describes the neurologic complications of childhood Rheumatic dis...

  6. Neuropsychiatric Manifestations of Parkinson`s Disease

    Directory of Open Access Journals (Sweden)

    Ana Peixinho

    2014-10-01

    Full Text Available Parkinson’s disease affects about 1% of the world population older than 65 years. It’s most frequently considered a movement disorder, but the neuropsychiatric manifestations associated with the disease and/or its treatment may be of equal or greater significance in some patients. We will discuss briefly the epidemiology, physiopathology and diagnosis of Parkinson’s disease, highlighting the neuropsychiatric manifestations: depression, anxiety, psychosis, dementia, sleep disorders, dopamine dysregulation syndrome.

  7. Augmenting SCORM Manifests with Adaptive Links

    OpenAIRE

    Abdullah, NA; Bailey, CP; Davis, HC

    2004-01-01

    This paper describes an experiment to augment SCORM manifests with adaptive links using AuldLinky in order to promote content reusability, interoperability and personalized e-learning. Our technique involves the automatic deduction of a concept map from a manifest and the transformation of its pertinent elements into FOHM (Fundamental Object Hypermedia Model) objects before augmenting the information with complimentary and adaptive links using AuldLinky.

  8. Endocrine disorders and the neurologic manifestations

    OpenAIRE

    Yu, Jeesuk

    2014-01-01

    The nervous system and the endocrine system are closely interrelated and both involved intimately in maintaining homeostasis. Endocrine dysfunctions may lead to various neurologic manifestations such as headache, myopathy, and acute encephalopathy including coma. It is important to recognize the neurologic signs and symptoms caused by the endocrine disorders while managing endocrine disorders. This article provides an overview of the neurologic manifestations found in various endocrine disord...

  9. Current oral manifestations of HIV infection.

    Science.gov (United States)

    Navazesh, M

    2001-02-01

    The oral manifestations of human immunodeficiency virus infection have changed drastically since the introduction of the highly active anti-retroviral therapy (HAART) in developed countries. Recent studies have documented significant reductions in morbidity and mortality rates among HIV-infected patients on HAART. This article focuses on the latest information about the oral manifestations of HIV infection and will discuss the impact of HAART.

  10. Recurrent diarrhea as a manifestation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Tomohiko Murai

    2014-01-01

    . Among them is an uncommon syndrome called abdominal epilepsy in which gastrointestinal complaints are the primary or the sole manifestation of epileptic seizures. In patients who present with diarrhea and other autonomic symptoms otherwise unexplained, a possible diagnosis of epilepsy should be considered.

  11. Optimal approach to obtaining mucosal biopsies for assessment of inflammatory disorders of the gastrointestinal tract.

    Science.gov (United States)

    Yantiss, Rhonda K; Odze, Robert D

    2009-03-01

    Endoscopic evaluation and mucosal biopsy analysis have assumed important roles in the clinical management of patients with symptoms related to the gastrointestinal tract. Several common inflammatory diseases, including eosinophilic esophagitis, Barrett's esophagus, Helicobacter pylori infection, celiac disease, lymphocytic colitis, collagenous colitis, and inflammatory bowel disease, may display a patchy or discontinuous distribution and, thus, multiple mucosal samples may be required to obtain diagnostic tissue in some cases. Not surprisingly, clinicians and pathologists are increasingly challenged to determine the optimum number of procedures and tissue samples necessary to detect, or exclude, the presence of inflammatory disorders of the gastrointestinal tract. Unfortunately, clinical practice varies widely with respect to tissue sample procurement in the evaluation of these disorders, particularly when the endoscopic appearance of the gastrointestinal mucosa is normal or shows only minimal changes. Guidelines concerning the appropriate number of tissue samples are well established for some diseases, such as Barrett's esophagus and chronic gastritis, but are not clear in other instances. The purpose of this review is to discuss the available literature pertaining to appropriate endoscopic sampling in the assessment of medical diseases of the gastrointestinal tract, and to develop recommendations regarding the clinical evaluation of common gastrointestinal disorders. PMID:19209164

  12. Chronic Cough in Otorhinolaryngologic Routine

    Directory of Open Access Journals (Sweden)

    Palheta Neto, Francisco Xavier

    2011-04-01

    Full Text Available Introduction: The chronic cough is sometimes manifested as an imprecise symptom, but of great importance for both the diagnosis and the prognosis. In an otorhinolaryngologic approach, several illnesses that can occur with it can be numbered, including 2 of the 3 main causes of chronic cough. Objective: To identify the main otorhinolaryngologic diseases showing the chronic cough as one of their manifestations. Method: A literature's revision was performed in several scientific articles, specialized books and consultation in Birene and Scielo databases. Literature's revision: cough production in the upper airways is usually associated with an inflammatory reaction by stimulating sensitive receptors of these areas or by mechanic stimulus. The main cause of the chronic cough in the otorhinolaryngology day-to-day is the post-nasal drip, gathering together by itself 02 of the most common diseases: rhinitis and sinusitis. Laryngitis as a result of gastroesophageal reflux (GER stands out in the index of chronic cough etiology, but it is not as severe as GER . Neoplasias are also somewhat frequent causes of cough, and the difficulty in diagnosing the cough cause is common in this disease group. Motility disorder, laryngeal irritation persistence, parasitic disease and injuries by inhalation of toxic products were also found as a cause of cough for longer than 03 months. Conclusion:Chronic cough is a frequent and important finding in otorhinolaryngology and cannot be underestimated, and a careful anamnesis is the best way to determine the etiology and perform a correct treatment for the patient's disease.

  13. Devil's claw root: ulcers and gastrointestinal bleeding?

    Science.gov (United States)

    2013-12-01

    Harpagophytum procumbens, or devil's claw, is an African plant whose root is used to relieve minor joint symptoms. Several cases of gastrointestinal bleeding associated with the use of devil's claw root have been reported. A systematic review of the adverse effects of devil's claw root in about 20 randomised, double-blind, placebo-controlled clinical trials showed mainly gastrointestinal effects: gastralgia and dyspepsia. In practice, devil's claw root exposes patients to the risk of sometimes serious upper gastrointestinal disorders, yet has no established efficacy beyond a placebo effect. It is best avoided. PMID:24600731

  14. [Metagenomics in studying gastrointestinal tract microorganism].

    Science.gov (United States)

    Xu, Bo; Yang, Yunjuan; Li, Junjun; Tang, Xianghua; Mu, Yuelin; Huang, Zunxi

    2013-12-01

    Animal gastrointestinal tract contains a complex community of microbes, whose composition ultimately reflects the co-evolution of microorganisms with their animal host. The gut microbial community of humans and animals has received significant attention from researchers because of its association with health and disease. The application of metagenomics technology enables researchers to study not only the microbial composition but also the function of microbes in the gastrointestinal tract. In this paper, combined with our own findings, we summarized advances in studying gastrointestinal tract microorganism with metagenomics and the bioinformatics technology.

  15. 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.

  16. Post-infectious irritable bowel syndrome: mechanistic insights into chronic disturbances following enteric infection.

    Science.gov (United States)

    Beatty, Jennifer K; Bhargava, Amol; Buret, Andre G

    2014-04-14

    Irritable bowel syndrome (IBS) is a commonly encountered chronic functional gastrointestinal (GI) disorder. Approximately 10% of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery. The appearance of new IBS symptoms following an infectious event is defined as post-infectious-IBS. Indeed, with the World Health Organization estimating between 2 and 4 billion cases annually, infectious diarrheal disease represents an incredible international healthcare burden. Additionally, compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features. A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota, epithelial barrier integrity, effector cell functions, and innate and adaptive immune features, all proposed physiological manifestations that can underlie GI abnormalities in IBS. Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms, and illicit successful infections. Consequently, the impact of infectious events on host physiology can be multidimensional in terms of anatomical location, functional scope, and duration. This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease, but may also lead to the establishment of chronic GI dysfunction compatible with IBS. PMID:24744587

  17. Holobiont nutrition: Considering the role of the gastrointestinal microbiota in the health benefits of whole grains

    OpenAIRE

    Walter, Jens; Martínez, Inés; Rose, Devin J.

    2013-01-01

    Intake of whole grains and other food products high in dietary fiber have long been linked to the prevention of chronic diseases associated with inflammation. A contribution of the gastrointestinal microbiota to these effects has been suggested, but little is known on how whole grains interact with gut bacteria. We have recently published the first human trial that made use of next-generation sequencing to determine the effect of whole grains (whole grain barley, brown rice or a mixture of th...

  18. The Management of Gastrointestinal Stromal Tumors: A Model for Targeted and Multidisciplinary Therapy of Malignancy

    OpenAIRE

    Joensuu, Heikki; DeMatteo, Ronald P.

    2011-01-01

    Gastrointestinal stromal tumor (GIST) has become a model for targeted therapy in cancer. The vast majority of GISTs contain an activating mutation in either the KIT or platelet-derived growth factor A (PDGFRA) gene. GIST is highly responsive to several selective tyrosine kinase inhibitors. In fact, this cancer has been converted to a chronic disease in some patients. Considerable progress has been made recently in our understanding of the natural history and molecular biology of GIST, risk st...

  19. Usefulness of duodenal biopsy during routine upper gastrointestinal endoscopy for diagnosis of celiac disease

    Institute of Scientific and Technical Information of China (English)

    S Riestra; F Domínguez; E Fernández-Ruiz; E García-Riesco; R Nieto; E Fernández; L Rodrigo

    2006-01-01

    AIM: To describe the trend in duodenal biopsy performance during routine upper gastrointestinal endoscopy in an adult Spanish population, and to analyze its value for the diagnosis of celiac disease in clinical practice.METHODS: A 15 year-trend (1990 to 2004) in duodenal biopsy performed when undertaking upper gastrointestinal endoscopy was studied. We analysed the prevalence of celiac disease in the overall group, and in the subgroups with anaemia and/or chronic diarrhoea.RESULTS: Duodenal biopsy was performed in 1033of 13 678 upper gastrointestinal endoscopies (7.6%);an increase in the use of such was observed over the study period (1.9% in 1990-1994, 5% in 1995-1999 and 12.8% in 2000-2004). Celiac disease was diagnosed in 22 patients (2.2%), this being more frequent in women than in men (3% and 1% respectively). Fourteen out of 514 (2.7%) patients with anaemia, 12 out of 141(8.5%) with chronic diarrhoea and 8 out of 42 (19%)with anaemia plus chronic diarrhoea had celiac disease.A classical clinical presentation was observed in 55% of the cases, 23% of the patients had associated dermatitis herpetiformis and 64% presented anaemia; 9% were diagnosed by familial screening and 5% by cryptogenetic hypertransaminasaemia.CONCLUSION: Duodenal biopsy undertaken during routine upper gastrointestinal endoscopy in adults, has been gradually incorporated into clinical practice, and is a useful tool for the diagnosis of celiac disease in high risk groups such as those with anaemia and/or chronic diarrhoea.

  20. The SAPHO syndrome revisited with an emphasis on spinal manifestations

    International Nuclear Information System (INIS)

    The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome includes a group of chronic, relapsing, inflammatory musculoskeletal disorders with similar manifestations, in particular synovitis, hyperostosis, and osteitis, which may or may not be associated with neutrophilic skin eruptions such as palmoplantar pustulosis and acne conglobata. The syndrome occurs at any age, can involve any skeletal site, and its imaging appearances are variable, depending on the stage/age of the lesion and imaging method. The diagnosis is difficult if there is no skin disease. Awareness of the imaging appearances, especially in the spine, may help the radiologist in avoiding misdiagnosis (e.g., infection, tumor) and unnecessary invasive procedures, while facilitating early diagnosis and selection of an effective treatment. In this article, we provide an overview of the radiological appearances of SAPHO syndrome, focusing on the magnetic resonance imaging findings of vertebral involvement, and present relevant clinical and pathological features that assist early diagnosis. (orig.)

  1. [Serrapeptase-induced lung injury manifesting as acute eosiniphilic pneumonia].

    Science.gov (United States)

    Sasaki, S; Kawanami, R; Motizuki, Y; Nakahara, Y; Kawamura, T; Tanaka, A; Watanabe, S

    2000-07-01

    An 84-year-old man was referred to our hospital because of fever, cough, and hemoptysis. The patient had acute respiratory failure (PaO2 < 40 mmHg) on admission, with diffuse interstitial infiltration and bilateral pleural effusion. The bronchoalveolar lavage fluid was bloody, and contained a high percentage of eosinophils (32%). A diagnosis of acute eosinophilic pneumonia was established, and the patient made a rapid recovery after corticosteroids were administered. When the DLST (drug lymphocyte stimulation test) was performed after the corticosteroid therapy was stopped, it was positive for serrapeptase, which had been prescribed for chronic cystitis for 3 months before the onset of the pneumonia. This was a case of drug (serrapeptase)-induced pneumonitis manifesting as acute eosinophilic pneumonia.

  2. [Consequences of extrahepatic manifestations of hepatitis C viral infection (HCV)].

    Science.gov (United States)

    Pawełczyk, Agnieszka

    2016-01-01

    The hepatitis C virus (HCV) is a primarily hepatotropic virus. However, numerous extrahepatic symptoms are observed in patients chronically infected with HCV, e.g. cryoglobulinemia, lymphoproliferative disorders, kidney diseases, disturbances of the central and peripheral nervous system, thyroid gland, pancreas, lymph nodes and pituitary gland, that develop at various times after the infection. Complex mechanisms underlie these processes, both molecular, related to direct effects of the virus on cells or tissues and indirect mechanisms, resulting from the response of the immune system to infection (via cytokines or oxidative stress), and from the antiviral treatment used. Understanding these mechanisms may contribute to the definition of new prognostic factors, important for the early diagnosis of the infection, which in turn may improve treatment efficacy. This paper is a review of the incidence of selected extrahepatic manifestations of HCV infection and their underlying pathogenetic mechanisms and risk factors. PMID:27117111

  3. Oral Manifestations of Inflammatory Bowel Diseases: Two Case Reports

    Science.gov (United States)

    Pereira, Manoela Seadi; Munerato, Maria Cristina

    2016-01-01

    Inflammatory bowel diseases (IBD) are known as chronic inflammatory disorders of the digestive tract, represented mainly by Crohn’s disease (CD) and ulcerative colitis (UC). Among the main oral manifestations of IBD are cobblestoning of the oral mucosa, labial swellings with vertical fissures, pyostomatitis vegetans, angular cheilitis, perioral erythema, and glossitis. In this sense, understanding these nosological entities by dentists would help reach early and differential diagnosis. Thus, two case reports are presented and discussed based on theoretical references obtained by a literature review. The first case report refers to an adult patient whose IBD diagnosis was established after stomatological assessment. The second case was a patient with CD diagnosed in childhood with characteristic oral lesions. PMID:26864508

  4. The SAPHO syndrome revisited with an emphasis on spinal manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Leone, Antonio; Casale, Roberto; Magarelli, Nicola; Semprini, Alessia; Colosimo, Cesare [Catholic University, School of Medicine, Department of Radiological Sciences, Rome (Italy); Cassar-Pullicino, Victor N. [The Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Department of Diagnostic Imaging, Shropshire, England (United Kingdom)

    2015-01-15

    The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome includes a group of chronic, relapsing, inflammatory musculoskeletal disorders with similar manifestations, in particular synovitis, hyperostosis, and osteitis, which may or may not be associated with neutrophilic skin eruptions such as palmoplantar pustulosis and acne conglobata. The syndrome occurs at any age, can involve any skeletal site, and its imaging appearances are variable, depending on the stage/age of the lesion and imaging method. The diagnosis is difficult if there is no skin disease. Awareness of the imaging appearances, especially in the spine, may help the radiologist in avoiding misdiagnosis (e.g., infection, tumor) and unnecessary invasive procedures, while facilitating early diagnosis and selection of an effective treatment. In this article, we provide an overview of the radiological appearances of SAPHO syndrome, focusing on the magnetic resonance imaging findings of vertebral involvement, and present relevant clinical and pathological features that assist early diagnosis. (orig.)

  5. T Helper Cell Subsets in Clinical Manifestations of Psoriasis

    Directory of Open Access Journals (Sweden)

    Marco Diani

    2016-01-01

    Full Text Available Psoriasis is a chronic inflammatory skin disease, which is associated with systemic inflammation and comorbidities, such as psoriatic arthritis and cardiovascular diseases. The autoimmune nature of psoriasis has been established only recently, conferring a central role to epidermal CD8 T cells recognizing self-epitopes in the initial phase of the disease. Different subsets of helper cells have also been reported as key players in the psoriasis pathogenesis. Here, we reviewed the knowledge on the role of each subset in the psoriatic cascade and in the different clinical manifestations of the disease. We will discuss the role of Th1 and Th17 cells in the initiation and in the amplification phase of cutaneous inflammation. Moreover, we will discuss the recently proposed role of tissue resident Th22 cells in disease memory in sites of recurrent psoriasis and the possible involvement of Th9 cells. Finally, we will discuss the hypothesis of a link between T helper cell subsets recirculating from the skin and the systemic manifestations of psoriasis.

  6. T Helper Cell Subsets in Clinical Manifestations of Psoriasis

    Science.gov (United States)

    Diani, Marco; Altomare, Gianfranco

    2016-01-01

    Psoriasis is a chronic inflammatory skin disease, which is associated with systemic inflammation and comorbidities, such as psoriatic arthritis and cardiovascular diseases. The autoimmune nature of psoriasis has been established only recently, conferring a central role to epidermal CD8 T cells recognizing self-epitopes in the initial phase of the disease. Different subsets of helper cells have also been reported as key players in the psoriasis pathogenesis. Here, we reviewed the knowledge on the role of each subset in the psoriatic cascade and in the different clinical manifestations of the disease. We will discuss the role of Th1 and Th17 cells in the initiation and in the amplification phase of cutaneous inflammation. Moreover, we will discuss the recently proposed role of tissue resident Th22 cells in disease memory in sites of recurrent psoriasis and the possible involvement of Th9 cells. Finally, we will discuss the hypothesis of a link between T helper cell subsets recirculating from the skin and the systemic manifestations of psoriasis. PMID:27595115

  7. Manifestations of paediatric Leishmania infantum infections in Malta.

    Science.gov (United States)

    Pace, David; Williams, Thomas N; Grochowska, Alicja; Betts, Alexandra; Attard-Montalto, Simon; Boffa, Michael J; Vella, Cecil

    2011-01-01

    Leishmania infantum is endemic in the Maltese archipelago, a group of islands in the Mediterranean which are visited frequently by tourists from Northern European countries. The burden of leishmaniasis is highest in children who may present with cutaneous or visceral manifestations. We describe systematically the manifestations, diagnosis and management of leishmaniasis in children Malta, from 2004 to 2008. Eleven children were diagnosed with leishmaniasis; 8 children (15-44 months of age) had visceral disease and three (aged 9-13 years) suffered cutaneous infections. Prolonged high grade fever, pallor, hepatosplenomegaly, and pancytopenia were common presenting features of visceralisation. Diagnosis was based on the visualisation of amastigotes from bone marrow aspirates. Pentavalent antimonials were associated with treatment failure in two children, whilst liposomal amphotericin B was curative in all. Children with cutaneous leishmaniasis had dry crusted ulcero-nodular lesions on exposed areas which responded to intra-lesional instillation of sodium stibogluconate or to cryotherapy. Leishmaniasis should be included in the differential diagnosis of fever and hepatosplenomegaly or chronic cutaneous lesions in children who travel to Malta.

  8. 14 CFR 121.693 - Load manifest: All certificate holders.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Load manifest: All certificate holders. 121... manifest: All certificate holders. The load manifest must contain the following information concerning the... certificate holder....

  9. Celiac disease presenting with extraintestinal manifestations

    Directory of Open Access Journals (Sweden)

    Fikri Ak

    2010-12-01

    Full Text Available Celiac disease (CD is a multiorgan involved systemic disease that most commonly affects the gut but also affects other organs. Up to 10% of patients with CD and gastrointestinal symptoms have otherwise unexplained neurological presentations. In this paper we report a case with the final diagnosis of celiac disease while being investigated for the underlying etiology of iron deficient anemia, peripheral neuropathy, and gait and speech disturbances. J Clin Exp Invest 2010; 1(3: 211-213

  10. Renal imaging in children with chronic kidney disease

    OpenAIRE

    Wiwit Rahmawati; Heru Muryawan; Farah Prabowo

    2013-01-01

    Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were in...

  11. How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

    OpenAIRE

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-01-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the v...

  12. Factors affecting hospital mortality in acute upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Alam Mohammed

    2000-01-01

    Full Text Available This retrospective analysis studied the records of 564 consecutive patients admitted to Gastrointestinal Bleeding Unit of Riyadh Medical Complex with acute upper gastrointestinal bleeding over a 2-year period (May 1996-April 1998. The purpose of the study was to analyze the mortality with an aim to identify the risk factors affecting mortality in these patients. Majority of patients were men (82% and Saudis (54%. Their mean age was 52.46 + 17.8 years. Esophageal varices (45% were the main causes of bleeding followed by duodenal ulcers (24%. Overall mortality in this series was 15.8% (89 patients. Comorbid diseases were responsible for death in 68 (76% patients, whereas, bleeding was considered to be directly responsible for death in 21 (24% patients. On analysis of data from this study, old age (>60 years, systolic pressure < 90 mm Hg on admission, comorbid disease, variceal bleeding and Child′s grade C in patients with chronic liver disease were associated with adverse outcome.

  13. Nocturnal manifestations of atypical parkinsonian disorders.

    Science.gov (United States)

    Bhidayasiri, Roongroj; Jitkritsadakul, Onanong; Colosimo, Carlo

    2014-01-01

    Although nocturnal disturbances are increasingly recognized as an integral part of the continuum of daytime manifestations of Parkinson's disease (PD), there is still little evidence in the medical literature to support the occurrence of these complex phenomena in patients with atypical parkinsonian disorders (APDs). Based on the anatomical substrates in APDs, which are considered to be more extensive outside the basal ganglia than in PD, we might expect that patients with APDs encounter the whole range of nocturnal disturbances, including motor, sleep disorders, autonomic dysfunctions, and neuropsychiatric manifestations at a similar, or even greater, frequency than in PD. This article is a review of the current literature on the problems at nighttime of patients with progressive supranuclear palsy, multiple system atrophy, corticobasal degeneration, and dementia with Lewy bodies. MEDLINE, life science journals and online books were searched by querying appropriate key words. Reports were included if the studies were related to nocturnal manifestations in APDs. Forty articles fulfilled the selection criteria. Differences between these symptoms in APDs and PD are highlighted, given the evidence available about each manifestation. This analysis of nocturnal manifestations of APDs suggests the need for future studies to address these issues to improve the quality of life not only of patients with APDs but the caregivers who encounter the challenges of supporting these patients on a daily basis.

  14. Histiocytic disorders of the gastrointestinal tract

    DEFF Research Database (Denmark)

    Detlefsen, Sönke; Fagerberg, Christina R; Ousager, Lilian Bomme;

    2013-01-01

    a short review on histiocytic disorders of the gastrointestinal tract in general. The primary histiocytic disorders of uncertain origin, Rosai-Dorfman disease, Langerhans cell histiocytosis, and Erdheim-Chester disease, are addressed. Reactive and infectious conditions such as xanthomatosis...

  15. Ketamine Sedation in Gastrointestinal Endoscopy in Children

    Directory of Open Access Journals (Sweden)

    Ayman E. Eskander

    2016-07-01

    CONCLUSION: Ketamine sedation found to be safe for paediatric gastrointestinal endoscopy in Egyptian children without co-morbidities. Transient Hypoxia (13% may occur but easily reversed by nasal oxygen therapy.

  16. Targeted therapies in upper gastrointestinal cancer

    NARCIS (Netherlands)

    S. Kordes

    2016-01-01

    Upper gastrointestinal (GI) cancers, as esophageal, gastric and pancreatic cancer, are still highly lethal diseases, in spite of advances in surgery, radiotherapy, chemotherapy and specific targeted therapy. Especially when patients are diagnosed with locally advanced or metastasized disease, upper

  17. A coprological investigation of gastrointestinal and cardiopulmonary parasites in hunting dogs in Denmark

    DEFF Research Database (Denmark)

    Al-Sabi, Mohammad Nafi Solaiman; Kapel, Christian Moliin Outzen; Johansson, Anna;

    2013-01-01

    species of parasite was more common (89.5%) than infectionwith two species (10.5%). A multiple logistic regression model showed that prevalence ofintestinal parasites was not influenced by age, gender or breed in adult dogs. There was asignificantly higher prevalence of intestinal parasites in the densely......A coprological survey was conducted to investigate the prevalence of parasites infect-ing hunting dogs with no history of recent anthelmintic treatments and with no overtclinical manifestations of cardiopulmonary or gastrointestinal illness. The hunting dogswere recruited from four different areas...... in Denmark, and fecal samples were obtainedin October and November, 2007. For detecting gastrointestinal parasites, samples (N = 178)were examined by a commercial flotation kit (Fecalyzer®EVSCO, USA). For detection of car-diopulmonary parasites, samples (N = 181) were collected on three consecutive days...

  18. Tumour markers in gastrointestinal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lamerz, R.

    1988-02-01

    For non-endocrine gastrointestinal tumours the following tumour markers are of clinical interest: For esophageal cancer CEA (sensitivity, s: 40-60%) and SCC (squamous cell carcinoma antigen, x: 20-50%); for gastric cancer CEA (s: 30-40%) as well as CA 19-9 (s: 30-40%) because of complementary results (additive s: 50-60); for hepatocellular cancer AFP (first choice, s: 70-90%; second choice CA 19-9, s: 50-70%); for cholangiocellular cancer CA 19-9 (s: 40-70%); for secondary liver cancer in general CEA; for biliary tract cancer CA 19-9 (s: 40-70%) as well as for excretory pancreatic cancer (s: 70-90%); for colorectal cancer CEA (s: 40-70%) as a first choice marker, and CA 19-9 (s: 20-60%) as a second choice marker, and for anal cancer SCC. The frequency of tumour marker determinations depends on follow-up care recommendations for different tumour diseases (e.g. 1-3 monthly during the 1st and 2nd postoperative year, following chemotherapy courses, on change of therapy, on restaging and at unclear alteration of the clinical state). Tumour markers are only valuable adjuncts to the medical care of tumour patients and therefore useless as solitary findings or on missing therapeutic consequence.

  19. Multicentric malignant gastrointestinal stromal tumor

    International Nuclear Information System (INIS)

    Malignant gastrointestinal stromal tumor (GIST) is a rare type of sarcoma that is found in the digestive system, most often in the wall of the stomach. Multiple GISTs are extremely rare and usually associated with type 1 neurofibromatosis and familial GIST. We report here a case of a 70-year-old woman who reported pain in the abdomen, loss of appetite, and weight loss for six months. Ultrasound examination showed a small bowel mass along with multiple peritoneal deposits and a mass within the liver. Barium studies were suggestive of a neoplastic pathology of the distal ileum. A differential diagnosis of adenocarcinoma/lymphoma with metastases was entertained. Perioperative findings showed two large growths arising from the jejunum and the distal ileum, along with multiple smaller nodules on the serosal surface and adjoining mesentery of the involved bowel segments. Segmental resection of the involved portions of the intestine was performed. Histopathological features were consistent with those of multicentric malignant GIST-not otherwise specified (GIST-NOS). Follow-up examination three months after surgery showed no evidence of recurrence. (author)

  20. Multicentric malignant gastrointestinal stromal tumor.

    Science.gov (United States)

    Shukla, Shailaja; Singh, Sanjeet K; Pujani, Mukta

    2009-01-01

    Malignant gastrointestinal stromal tumor (GIST) is a rare type of sarcoma that is found in the digestive system, most often in the wall of the stomach. Multiple GISTs are extremely rare and usually associated with type 1 neurofibromatosis and familial GIST.We report here a case of a 70-year-old woman who reported pain in the abdomen, loss of appetite, and weight loss for six months. Ultrasound examination showed a small bowel mass along with multiple peritoneal deposits and a mass within the liver. Barium studies were suggestive of a neoplastic pathology of the distal ileum. A differential diagnosis of adenocarcinoma/lymphoma with metastases was entertained. Perioperative findings showed two large growths arising from the jejunum and the distal ileum, along with multiple smaller nodules on the serosal surface and adjoining mesentery of the involved bowel segments. Segmental resection of the involved portions of the intestine was performed. Histopathological features were consistent with those of multicentric malignant GIST-not otherwise specified (GIST-NOS). Follow-up examination three months after surgery showed no evidence of recurrence. PMID:19568556

  1. Multicentric malignant gastrointestinal stromal tumor

    Directory of Open Access Journals (Sweden)

    Shukla Shailaja

    2009-01-01

    Full Text Available Malignant gastrointestinal stromal tumor (GIST is a rare type of sarcoma that is found in the digestive system, most often in the wall of the stomach. Multiple GISTs are extremely rare and usually associated with type 1 neurofibromatosis and familial GIST. We report here a case of a 70-year-old woman who reported pain in the abdomen, loss of appetite, and weight loss for six months. Ultrasound examination showed a small bowel mass along with multiple peritoneal deposits and a mass within the liver. Barium studies were suggestive of a neoplastic pathology of the distal ileum. A differential diagnosis of adenocarcinoma/lymphoma with metastases was entertained. Perioperative findings showed two large growths arising from the jejunum and the distal ileum, along with multiple smaller nodules on the serosal surface and adjoining mesentery of the involved bowel segments. Segmental resection of the involved portions of the intestine was performed. Histopathological features were consistent with those of multicentric malignant GIST-not otherwise specified (GIST-NOS. Follow-up examination three months after surgery showed no evidence of recurrence.

  2. Potassium Channelopathies and Gastrointestinal Ulceration

    Science.gov (United States)

    Han, Jaeyong; Lee, Seung Hun; Giebisch, Gerhard; Wang, Tong

    2016-01-01

    Potassium channels and transporters maintain potassium homeostasis and play significant roles in several different biological actions via potassium ion regulation. In previous decades, the key revelations that potassium channels and transporters are involved in the production of gastric acid and the regulation of secretion in the stomach have been recognized. Drugs used to treat peptic ulceration are often potassium transporter inhibitors. It has also been reported that potassium channels are involved in ulcerative colitis. Direct toxicity to the intestines from nonsteroidal anti-inflammatory drugs has been associated with altered potassium channel activities. Several reports have indicated that the long-term use of the antianginal drug Nicorandil, an adenosine triphosphate-sensitive potassium channel opener, increases the chances of ulceration and perforation from the oral to anal regions throughout the gastrointestinal (GI) tract. Several of these drug features provide further insights into the role of potassium channels in the occurrence of ulceration in the GI tract. The purpose of this review is to investigate whether potassium channelopathies are involved in the mechanisms responsible for ulceration that occurs throughout the GI tract. PMID:27784845

  3. [Chronic inflammatory demyelinating polyradiculoneuropathy].

    Science.gov (United States)

    Franques, J; Azulay, J-P; Pouget, J; Attarian, S

    2010-06-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a demyelinating chronic neuropathy of immune origin whose diagnosis is based upon clinical, biological and electrophysiological data; previously critical to the diagnosis the nerve biopsy is now restricted to the rare situations where accurate diagnosis cannot be reached using these data alone. CIDP are mainly idiopathic, but a few associated diseases must be sought for as they require specific attention. Such associated diseases must particularly be discussed when the manifestations are severe or resistant to immunomodulating or immunosuppressive agents. Indeed, idiopathic CIDP are usually responsive to these treatments. The effectiveness of these treatments is limited by the importance of the secondary axonal loss. The dependence or the resistance may sometimes justify the association of several immunomodulating treatments. A single randomized controlled trial support the use of cytotoxic drugs and none with rituximab.

  4. Gastrointestinal and hepatic complications of hematopoietic stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    Hande H Tuncer; Naveed Rana; Cannon Milani; Angela Darko; Samer A Al-Homsi

    2012-01-01

    Recognition and management of gastrointestinal and hepatic complications of hematopoietic stem cell transplantation has gained increasing importance as indications and techniques of transplantation have expanded in the last few years.The transplant recipient is at risk for several complications including conditioning chemotherapy related toxicities,infections,bleeding,sinusoidal obstruction syndrome,acute and chronic graftversus-host disease (GVHD) as well as other long-term problems.The severity and the incidence of many complications have improved in the past several years as the intensity of conditioning regimens has diminished and better supportive care and GVHD prevention strategies have been implemented.Transplant clinicians,however,continue to be challenged with problems arising from human leukocyte antigen-mismatched and unrelated donor transplants,expanding transplant indications and age-limit.This review describes the most commonly seen transplant related complications,focusing on their pathogenesis,differential diagnosis and management.

  5. MR imaging of the gastro-intestinal tract in children

    International Nuclear Information System (INIS)

    MR imaging (MRI) is an established method for the evaluation of particularly inflammatory bowel disease in adults, as well as for acute abdominal pain in pregnant women. Despite the fact that MRI is ideally suited for the evaluation of children the method is still not established in these patients. The value of MRI in Crohn's disease, ulcerative colitis and appendicitis as well as intestinal tumors and malformations has been documented in children. There will be more indications in the future depending on the development of new imaging techniques, faster sequences, stronger gradients and increasing availability. Furthermore, the radiologist's attention must be drawn to decrease the radiation burden in children and to replace ionizing techniques especially in chronic disease with the need for repeated follow-up studies and in younger children. This review will discuss some general considerations for the use of MRI in evaluating the paediatric gastro-intestinal tract

  6. MR imaging of the gastro-intestinal tract in children

    Energy Technology Data Exchange (ETDEWEB)

    Hoermann, Marcus [Medical University of Vienna/General Hospital, Department of General and Paediatric Radiology, Waehringerguertel 18-20, A-1090 Vienna (Austria)], E-mail: marcus.hoermann@meduniwien.ac.at

    2008-11-15

    MR imaging (MRI) is an established method for the evaluation of particularly inflammatory bowel disease in adults, as well as for acute abdominal pain in pregnant women. Despite the fact that MRI is ideally suited for the evaluation of children the method is still not established in these patients. The value of MRI in Crohn's disease, ulcerative colitis and appendicitis as well as intestinal tumors and malformations has been documented in children. There will be more indications in the future depending on the development of new imaging techniques, faster sequences, stronger gradients and increasing availability. Furthermore, the radiologist's attention must be drawn to decrease the radiation burden in children and to replace ionizing techniques especially in chronic disease with the need for repeated follow-up studies and in younger children. This review will discuss some general considerations for the use of MRI in evaluating the paediatric gastro-intestinal tract.

  7. GEIS 2013 guidelines for gastrointestinal sarcomas (GIST)

    OpenAIRE

    Poveda, Andrés; del Muro, Xavier García; López-Guerrero, Jose Antonio; Martínez, Virginia; Romero, Ignacio; Valverde, Claudia; Cubedo, Ricardo; Martín-Broto, Javier

    2014-01-01

    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal soft tissue sarcoma of the gastrointestinal tract. Correct diagnosis with thorough use of pathologic and molecular tools of GIST mutations has been of the foremost importance. GIST are usually (95 %) KIT positive and harbor frequent KIT or platelet-derived growth factor receptor α-activating mutations. This deep molecular understanding has allowed the correct classification into risk groups with implications regarding prog...

  8. Gastrointestinal autonomic nerve tumor of the stomach

    OpenAIRE

    Meshikhes, Abdul-Wahed N.; Al-Garni, Ayed A.; Sami A Al-Momen; Al-Nahawi, Mamdouh; Abu Subaih, Jawad

    2014-01-01

    Patient: Female, 32 Final Diagnosis: Gastrintestinal Autonomic Nerve Tumor (GANT) Symptoms: anemia • anorexia • fatigue • fever • hearburn • nausea • weight loss Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Gastrointestinal autonomic nerve tumors (GANT) are extremely rare tumors that are related to gastrointestinal autonomic nervous plexuses. They are distinguished from stromal tumors by their unique ultrastructural feature...

  9. Stress, Anxiety and Functional Gastrointestinal Disorders

    OpenAIRE

    Sermin Kesebir; Semra Ocak Karatas; Cigdem Bezgin; Fatma Cengiz

    2012-01-01

    Stress has major role in functional gastrointestinal system disorders. The most typical example of this situation is Irritable bowel syndrome. Gastrointestinal system’s response to acute or short-term of stress is delay of gastric emptying and stimulation of colonic transition. While CRF2 receptors are mediate the upper section inhibition, CRF1 is responsible for the lower part colonic and anxiogenic response. Visceral hypersensitivity is managed by the emotional motor system, the amygd...

  10. Imaging spectrum of gastrointestinal stromal tumor

    Directory of Open Access Journals (Sweden)

    Binit Sureka

    2014-01-01

    Full Text Available Gastrointestinal stromal tumors (GISTs were first described by Clark and Mazur in 1983 for smooth muscle neoplasms of the gastrointestinal tract differentiating them from leiomyoma, leiomyosarcomas and neurogenic tumors. GISTs can arise from the bowel, peritoneum, omentum or retroperitoneum. This article reviews the computed tomography imaging features of primary GISTs, response to treatment and highlights data on predicting the outcome to chemotherapeutic drugs on imaging.

  11. Anaphylactoid reactions with gastrointestinal contrast media.

    Science.gov (United States)

    Skucas, J

    1997-04-01

    Significant anaphylactoid reactions to gastrointestinal contrast media are rare. Whether a patient who is atopic or has asthma is predisposed to these reactions is speculative. The rare patient who previously had a severe allergic reaction to such a product probably should not undergo a subsequent examination with a similar agent. The American College of Radiology classification of contrast media side effects can also be applied to the gastrointestinal contrast media. PMID:9124150

  12. Risk assessment after acute upper gastrointestinal haemorrhage.

    OpenAIRE

    Rockall, T A; Logan, R F; Devlin, H. B.; Northfield, T. C.

    1996-01-01

    The aim of this study was to establish the relative importance of risk factors for mortality after acute upper gastrointestinal haemorrhage, and to formulate a simple numerical scoring system that categorizes patients by risk. A prospective, unselected, multicentre, population based study was undertaken using standardised questionnaires in two phases one year apart. A total of 4185 cases of acute upper gastrointestinal haemorrhage over the age of 16 identified over a four month period in 1993...

  13. Monitorering og iltbehandling ved gastrointestinal endoskopi

    DEFF Research Database (Denmark)

    Rosenberg, J

    1992-01-01

    Gastroenterological Societies in Britain and USA have published recommendations for sedation, monitoring and oxygen therapy during gastrointestinal endoscopy. No scientific basis for the introduction of recommendations such as these is, however, present as it has not yet been proved that hypoxaemia....... The scientific data available at present in this field is not conclusive. Introduction of recommendations for monitoring and oxygen therapy during gastrointestinal endoscopy in Denmark should be delayed until elucidation of the mechanisms involved has been undertaken....

  14. Vertigo as a Predominant Manifestation of Neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Tasnim F. Imran

    2015-01-01

    Full Text Available Sarcoidosis is a granulomatous disease of unknown etiology that affects multiple organ systems. Neurological manifestations of sarcoidosis are less common and can include cranial neuropathies and intracranial lesions. We report the case of a 21-year-old man who presented with vertigo and uveitis. Extensive workup including brain imaging revealed enhancing focal lesions. A lacrimal gland biopsy confirmed the diagnosis of sarcoidosis. The patient was initially treated with prednisone, which did not adequately control his symptoms, and then was switched to methotrexate with moderate symptomatic improvement. Our patient had an atypical presentation with vertigo as the predominant manifestation of sarcoidosis. Patients with neurosarcoidosis typically present with systemic involvement of sarcoidosis followed by neurologic involvement. Vertigo is rarely reported as an initial manifestation. This case highlights the importance of consideration of neurosarcoidosis as an entity even in patients that may not have a typical presentation or systemic involvement of disease.

  15. Cutaneous manifestations of systemic lupus erythematosus.

    Science.gov (United States)

    Uva, Luís; Miguel, Diana; Pinheiro, Catarina; Freitas, João Pedro; Marques Gomes, Manuel; Filipe, Paulo

    2012-01-01

    Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. The skin is one of the target organs most variably affected by the disease. The American College of Rheumatology (ACR) established 11 criteria as a classificatory instrument to operationalise the definition of SLE in clinical trials. They were not intended to be used to diagnose individuals and do not do well in that capacity. Cutaneous lesions account for four of these 11 revised criteria of SLE. Skin lesions in patients with lupus may be specific or nonspecific. This paper covers the SLE-specific cutaneous changes: malar rash, discoid rash, photosensitivity, and oral mucosal lesions as well as SLE nonspecific skin manifestations, their pathophysiology, and management. A deeper thorough understanding of the cutaneous manifestations of SLE is essential for diagnosis, prognosis, and efficient management. Thus, dermatologists should cooperate with other specialties to provide optimal care of SLE patient. PMID:22888407

  16. Cutaneous Manifestations of Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Luís Uva

    2012-01-01

    Full Text Available Systemic lupus erythematosus (SLE is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. The skin is one of the target organs most variably affected by the disease. The American College of Rheumatology (ACR established 11 criteria as a classificatory instrument to operationalise the definition of SLE in clinical trials. They were not intended to be used to diagnose individuals and do not do well in that capacity. Cutaneous lesions account for four of these 11 revised criteria of SLE. Skin lesions in patients with lupus may be specific or nonspecific. This paper covers the SLE-specific cutaneous changes: malar rash, discoid rash, photosensitivity, and oral mucosal lesions as well as SLE nonspecific skin manifestations, their pathophysiology, and management. A deeper thorough understanding of the cutaneous manifestations of SLE is essential for diagnosis, prognosis, and efficient management. Thus, dermatologists should cooperate with other specialties to provide optimal care of SLE patient.

  17. Novel Cutaneous Manifestations of Pleuroparenchymal Fibroelastosis.

    Science.gov (United States)

    Lowther, Christopher M; Morrison, Annie O; Candelario, Nicole M; Khalafbeigi, Sheva; Cockerell, Clay J

    2016-10-01

    Pleuroparenchymal fibroelastosis (PPFE) is a rare progressive disease that manifests as parenchymal fibrosis of the upper lobe and pleura. Approximately 100 cases have been reported. Cutaneous manifestations of PPFE have not previously been described. Diagnosis is dependent on histologic identification of fibrosis with atypical elastic fibers, necessitating an invasive peripheral lung wedge biopsy.A 68-year-old male with a history of pleuroparenchymal fibroelastosis presented with an asymptomatic, telangiectatic erythematous eruption on bilateral lower extremities. Biopsies demonstrated a subtle perivascular infiltrate with marked increase in atypical elastic fibers, similar to the elastosis in the patient's lungs.This is the first documented case of cutaneous manifestations in PPFE. Clinicians need to be aware that cutaneous eruptions clinically simulating telangiectasia macularis eruptiva perstans but lacking a mast cell infiltrate histologically, may have increased abnormal elastic fibers. Thus, early recognition of these lesions in patients with an undefined restrictive lung disorder, may facilitate the diagnosis of PPFE in some patients.

  18. Ghrelin Cells in the Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    Ichiro Sakata

    2010-01-01

    Full Text Available Ghrelin is 28-amino-acid peptide that was discovered from the rat and human stomach in 1999. Since the discovery of ghrelin, various functions of ghrelin, including growth hormone release, feeding behavior, glucose metabolism, memory, and also antidepressant effects, have been studied. It has also been reported that ghrelin in the gastrointestinal tract has an important physiological effect on gastric acid secretion and gastrointestinal motility. Ghrelin has a unique structure that is modified by O-acylation with n-octanoic acid at third serine residues, and this modification enzyme has recently been identified and named ghrelin O-acyl transferase (GOAT. Ghrelin is considered to be a gut-brain peptide and is abundantly produced from endocrine cells in the gastrointestinal mucosa. In the gastrointestinal tract, ghrelin cells are most abundant in the stomach and are localized in gastric mucosal layers. Ghrelin cells are also widely distributed throughout the gastrointestinal tract. In addition, abundance of ghrelin cells in the gastric mucosa is evolutionally conserved from mammals to lower vertebrates, indicating that gastric ghrelin plays important roles for fundamental physiological functions. Ghrelin cells in the gastrointestinal tract are a major source of circulating plasma ghrelin, and thus understanding the physiology of these cells would reveal the biological significance of ghrelin.

  19. Life-Threatening Cardiac Manifestations of Pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Luiz R. Leite

    2010-01-01

    Full Text Available Pheochromocytoma is a catecholamine-secreting tumor of the adrenal glands, usually with benign manifestations, whose typical clinical presentation includes the triad of headache, palpitations and diaphoresis. However, a wide range of signs and symptoms may be present. In the cardiovascular system, the most common signs are labile hypertension and sinus tachycardia. Systolic heart failure and ST-segment deviations mimicking myocardial infarction have also been reported, as well as QT interval prolongation and, rarely, ventricular tachycardia. We describe a challenging diagnosis of pheochromocytoma with many cardiovascular manifestations, which could have been missed due to the absence of typical symptoms.

  20. Main Ocular Manifestations in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Sandra Saray Quignon Santana

    2009-12-01

    Full Text Available Rheumatoid arthritis is considered an autoimmune disease in which articular and extra articular manifestations are produced and contribute to alter the functional capacity of the individual. This study consists on performing a bibliographical review showing the main ocular manifestations in patients with rheumatoid arthritis. It is our purpose to give you our experiences to the students as well as the internal medicine, ophthalmology and rheumatologist residents about this topic. The ophthalmological consultation of sick patients contributes to the prevention of ocular illnesses which are characteristic of the base disease and improve the ocular health.

  1. Lupus as a paraneoplastic manifestation of cholangiocarcinoma.

    Science.gov (United States)

    González Amores, Yolanda; Hernando Rebollar, Sofía; Casado Bernabeu, Aida

    2016-05-01

    Tumors originating in the digestive system, like those in other areas, whether solid or otherwise, may present with extradigestive manifestations in the setting of a paraneoplastic syndrome. Systemic lupus erythematosus (SLE) is an autoimmune condition most commonly involving women of childbearing age. On occasion it represents a paraneoplastic manifestation heralding a primary tumor. Cancer suspicion is therefore a key element for newly diagnosed SLE cases with nonstandard epidemiology even in the absence of suggestive symptoms, and digestive tumors should be included in the differential diagnosis. PMID:26925842

  2. Nutritional influences in selected gastrointestinal diseases.

    Science.gov (United States)

    Lakatos, Peter Laszlo; Kiss, Lajos S; Miheller, Pal

    2011-01-01

    Nutritional factors, as sources of luminal antigens, have been thought to be important factors in the immunopathogenesis of numerous gastrointestinal diseases. In some diseases, the role of the nutritional component is causal in the susceptible host. Such diseases include celiac disease, a common heritable chronic inflammatory condition of the small intestine induced by dietary wheat, rye and barley, in susceptible individuals. Specific HLA-DQ2 and HLA-DQ8 risk alleles are necessary, but not sufficient, for disease development. The well-defined role of HLA-DQ heterodimers encoded by these alleles is to present cereal peptides to CD4+ T cells, activating an inflammatory immune response in the intestine. Genome-wide association studies have been performed which identified the IL2-IL21 risk locus and other genes with immune functions and key roles in thymic T-cell selection. Another example for this group is Wilson's disease, an autosomal recessive disorder of copper metabolism caused by mutation of the ATP7B gene, resulting in a defect of biliary copper excretion and toxic accumulation in the body, especially in the liver, brain and cornea, resulting in hepatic and/or neurological symptoms. In other diseases, however, the association is less well established. In such endeavor, epidemiological observations may become a valuable part of the overall investigations aimed at identifying dietary factors, which are involved in the initiation and perpetuation of the specific disease. As an example, relationships between nutrition and colorectal cancer have been hypothesized early on (e.g. folate, calcium, vitamin D, red meat). Similarly, intake of certain diet constituents like fat, refined sugar, fruits, vegetables and fiber was reported to be associated with the expression of inflammatory bowel diseases. In addition, in children with active Crohn's disease, enteral nutrition was found to be equally effective as corticosteroids in induction of remission, with mucosal

  3. Gastrointestinal problems in modern wars:clinical features and possible mechanisms

    Institute of Scientific and Technical Information of China (English)

    Wei-Feng Wang; Xiao-Xu Guo; Yun-Sheng Yang

    2015-01-01

    Gastrointestinal problems are common during wars, and they have exerted significant adverse effects on the health of service members involved in warfare. The spectrum of digestive diseases has varied during wars of different eras. At the end of the 20th century, new frontiers of military medical research emerged due to the occurrence of high-tech wars such as the Gulf War and the Kosovo War, in which ground combat was no longer the primary method of field operations. The risk to the military personnel who face trauma has been greatly reduced, but disease and non-battle injuries (DNBIs) such as neuropsychological disorders and digestive diseases seemed to be increased. Data revealed that gastrointestinal symptoms such as constipation, diarrhea, dyspepsia, and noncardiac chest pain are common among military personnel during modern wars. In addition, a large number of deployed soldiers and veterans who participated in recent wars presented with chronic gastrointestinal complaints, which fulfilled with the Rome III criteria for functional gastrointestinal disorders (FGIDs). It was also noted that many veterans who returned from the Gulf War suffered not only from chronic digestive symptoms but also from neuropsychological dysfunction; however, they also showed symptoms of other systems. Presently, this broad range of unexplained symptoms is known as “Gulf War syndrome”. The mechanism that underlies Gulf War syndrome remains unclear, but many factors have been associated with this syndrome such as war trauma, stress, infections, immune dysfunction, radiological factors, anthrax vaccination and so on. Some have questioned if the diagnosis of FGIDs can be reached given the complexity of the military situation. As a result, further studies are needed to elucidate the pathogenesis of gastrointestinal disease among military personnel.

  4. Rheumatic manifestations of primary and metastatic bone tumors and paraneoplastic bone disease.

    Science.gov (United States)

    Waimann, Christian A; Lu, Huifang; Suarez Almazor, Maria E

    2011-11-01

    Bone tumors can show a wide range of nonspecific rheumatic manifestations. The presence of unexplained or atypical chronic bone pain, an enlarging bone mass, neurovascular compression syndromes, or pathologic fractures should alert us to the possibility of a bone tumor causing these symptoms. These patients must undergo a complete physical examination; adequate imaging; and, if needed, a biopsy to confirm their diagnosis and offer them an opportune treatment. In addition, bone tumors and other malignancies can present remote clinical manifestations and unusual laboratory findings (eg, HOA, hypophosphatemia, hyperphosphaturia, and hypercalcemia) that may be the first and early manifestation of an occult cancer. These findings should motivate a cancer screening according to age, sex, and personal history. Cancer therapies also have a big impact on bone health, increasing the risk of osteoporosis, osteomalacia, and/or osteonecrosis. Rheumatologists should be aware of possible long-term adverse events of cancer treatment to avoid future complications.

  5. Gender Differentiation of Relationships Between Manifestations of Indirect Self-Destructiveness and Dimensions of Emotional Intelligence.

    Science.gov (United States)

    Tsirigotis, Konstantinos; Łuczak, Joanna

    2016-09-01

    The aim of this study has been to explore the gender differentiation of relationships between individual manifestations of indirect self-destructiveness and particular dimensions of emotional intelligence. A population of 260 individuals (130 women and 130 men) aged 20-30 (mean age of 24.5) was studied by using the Polish version of the Chronic Self-Destructiveness Scale (CS-DS) and INTE, i.e. the Polish version of the Assessing Emotions Scale (AES). Manifestations of indirect self-destructiveness showed significant correlations with INTE variables, and those correlations were mainly negative. Relationships between specific dimensions of emotional intelligence and specific manifestations of self-destructiveness differed between women and men. One of the most important differences was the relationship between transgression and ability to recognize emotions. The knowledge of the differentiation of the above relationships may allow to orient prophylactic and therapeutic actions, and adjust them to the specific gender. PMID:26589424

  6. Clinical manifestations and outcomes in severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    YANG Xuesong; YAO Wei; LIU Wenbin; LI Jun; LU Yumin

    2007-01-01

    In order to evaluate the clinical manifestations and outcomes of severe ulcerative colitis (UC),we retrospectively reviewed 41 patients with severe UC from 144 consecutively hospitalized UC cases from 1988 to 2004.Data recorded included onset,symptoms,signs,laboratory results,endoscopic,radiologic and pathologic findings,the clinical treatment process and follow-up.Of these severe cases,92.7%(38/41)had pancolitis.Clinically,36.9%(15/41)were categorized as first onset type,36.9%(15/41)were chronic persistent and 26.8%(11/41)were chronic recurrent.Steroids played a main role in the remission of severe UC(61.0%).Thirty-one cases(75.6%) were relieved by drug therapy.Seven cases(17.1%) progressed to the need for operation.An early age of onset,pancolitis,low hemoglobin and serum albumin levels,and the need for intravenous steroids tended to be associated with the need for surgery.In conclusion,most of the severe UC patients respond well to drug therapy,but for individuals who are unresponsive to drug therapy,or for those depending on steroids,after a reasonable duration of treatment,the necessity for surgery should be considered.

  7. Morphologic Features of Extrahepatic Manifestations of Hepatitis C Virus Infection

    Directory of Open Access Journals (Sweden)

    Huaibin M. Ko

    2012-01-01

    Full Text Available Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

  8. Real-Life Contextual Manifestations of Wisdom

    Science.gov (United States)

    Yang, Shih-Ying

    2008-01-01

    Wisdom pertains to managing human affairs, and it arises in highly contextualized situations. The present study aims to investigate manifestations of wisdom in real-life contexts through semi-structured interviews with 66 individuals nominated as wise persons. All nominees were ethnic Chinese from Taiwan, an East Asian country which has…

  9. Unusual thoracic manifestation of metastatic malignant melanoma

    Directory of Open Access Journals (Sweden)

    Mohan K

    2010-01-01

    Full Text Available Massive pleural effusion due to metastatic malignant melanoma is rare. We report a case of bilateral (massive on left side pleural effusion as a metastatic manifestation of cutaneous malignant melanoma. In our case, successful outcome of pleurodesis with vincristine is significant as this agent is rarely used.

  10. CT manifestations of pulmonary Langerhans cell histiocytosis

    International Nuclear Information System (INIS)

    Objective: To analyzes the CT manifestations of pulmonary Langerhans cell histiocytosis (PLCH). Methods: CT features of 11 patients with PLCH proved pathologically were analyzed retrospectively. Results: The main findings in 11 PLCHs were cysts and nodules. Two cases only had cysts, and 1 only had nodules, which most had cavitations. The other 8 cases showed cysts and nodules with 4 cases mainly manifested with cysts and nine mainly manifested with nodules. Two cases had pulmonary interstitial changes. One case only had cysts in the left upper lung field and 10 cases had lesions not only in the upper and middle but in the lower lung field, which 2 cases had more lesions in the lower and costo-phrenic angle field and 8 cases had less lesions in the costo-phrenic angle field. Three of these 8 cases had more lesions in the superior lobe and apical segment of lower lobe. Conclusion: CT manifestations of PLCH are helpful for the early diagnosis. (authors)

  11. 19 CFR 122.75 - Complete manifest.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Complete manifest. 122.75 Section 122.75 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Documents Required for Clearance and Permission To Depart;...

  12. Polymorphonuclear leucocyte function and previous yersinia arthritis: correlation of enhanced superoxide production with late manifestations.

    OpenAIRE

    Repo, H; Koivuranta-Vaara, P; Leirisalo-Repo, M

    1988-01-01

    Polymorphonuclear leucocyte (PMN) functions (migration in vitro, chemiluminescence, O-2 production, and aggregation) were studied in 32 patients with previous yersinia arthritis (YA). PMNs of 11 HLA-B27 positive patients who had chronic or recurrent inflammatory symptoms showed O-2 production significantly higher than that of PMNs of 11 HLA-B27 positive patients without late manifestations. Also, PMNs of both HLA-B27 positive and negative patients tended to show chemotactic and chemokinetic m...

  13. Exercise intolerance and systemic manifestations of pulmonary emphysema in a mouse model

    OpenAIRE

    Hasenfuss Gerd; Unsöld Bernhard; Michels Hellmuth; Raupach Tobias; Lüthje Lars; Kögler Harald; Andreas Stefan

    2009-01-01

    Abstract Background Systemic effects of chronic obstructive pulmonary disease (COPD) significantly contribute to severity and mortality of the disease. We aimed to develop a COPD/emphysema model exhibiting systemic manifestations of the disease. Methods Female NMRI mice were treated 5 times intratracheally with porcine pancreatic elastase (emphysema) or phosphate-buffered saline (control). Emphysema severity was quantified histologically by mean linear intercept, exercise tolerance by treadmi...

  14. Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms

    Institute of Scientific and Technical Information of China (English)

    Marek Wronski; Bogna Ziarkiewicz-Wroblewska; Barbara Gornicka; Wlodzimierz Cebulski; Maciej Slodkowski; Aleksander Wasiutynski; Ireneusz W Krasnodebski

    2006-01-01

    AIM: To review clinical and pathologic features of Gastrointestinal stromal tumors (GISTs) occurring synchronously with other primary gastrointestinal neoplasms.METHODS: 28 patients with primary GIST were treated at our institution between 1989 and 2005. Clinical and pathologic records were reviewed.RESULTS: The gastrointestinal stromal tumor occurred simultaneously with other primary GI malignancies in 14% of all patients with GIST. The synchronous stromal tumors were located in the stomach and were incidentally found during the operation. The coexistent neoplasms were colon adenocarcinoma, gastric cancer (2 cases) and gastric lymphoma.CONCLUSION: The synchronous occurrence of GISTs and other gastrointestinal malignancies is more common than it has been considered. The development of gastrointestinal stromal tumors and other neoplasms may involvethe same carcinogenic agents.

  15. 77 FR 54818 - Polychlorinated Biphenyls (PCBs): Revisions to Manifesting Regulations

    Science.gov (United States)

    2012-09-06

    ... AGENCY 40 CFR Part 761 RIN 2050-AG71 Polychlorinated Biphenyls (PCBs): Revisions to Manifesting... manifesting requirements for PCBs under TSCA to the manifesting requirements for hazardous waste under RCRA... bring into alignment, as much as possible, the manifesting requirements for PCBs to those of...

  16. Gastrointestinal Symptoms in Lysosmal Disease

    Directory of Open Access Journals (Sweden)

    Farid IMANZADEH

    2012-12-01

    Full Text Available  How to Cite this Article: Imanzadeh F. Gastrointestinal Symptoms in Lysosmal Disease. Iran J Child Neurol Autumn 2012; 6:4 (suppl. 1:17-18.pls see PDF. References: 1. Semenza  GL,  Pyeritz  RE.  Respiratory complications of mucopolysaccharide storage disorders. Medicine (Baltimore 1988; 67:209. 2.   Wraith   JE,   Scarpa   M,   Beck   M,   et   al. Mucopolysaccharidosis type II (Hunter syndrome: a clinical review and recommendations for treatment in the era of enzyme replacement therapy. Eur J Pediatr 2008; 167:267. 3. Stevens JM, Kendall BE, Crockard HA, Ransford   A.   The   odontoid   process   in Morquio-Brailsford’s disease. The effects of occipitocervical fusion. J Bone Joint Surg Br 1991; 73:851. 4.   Jones AE, Croley TF. Morquio syndrome and anesthesia. Anesthesiology 1979; 51:261. 5.   Ashraf J, Crockard HA, Ransford AO, Stevens JM. Transoral decompression and posterior stabilisation in Morquio’s disease. Arch Dis Child 1991; 66:1318. 6.  Neufeld EF, Muenzer J. The metabolic and molecular bases of inherited disease, Scriver C, Beaudet AL, Valle D, Sly W (Eds, McGraw- Hill, New York 2001. p.3421. 7.   Wraith   JE.   The   mucopolysaccharidoses:   a clinical review and guide to management. Arch Dis Child 1995; 72:263. 8.   Cleary MA, Wraith JE. The presenting features of mucopolysaccharidosis type IH (Hurler syndrome. Acta Paediatr 1995; 84:337. 9.   Elsner B. Ultrastructure of the rectal wall in Hunter’s   syndrome.   Gastroenterology   1970; 58:856. 10. Cleary   MA,   Wraith   JE.   Management   of mucopolysaccharidosis type III. Arch Dis Child 1993; 69:403. 

  17. Helicobacter pylori and Gastrointestinal Malignancies.

    Science.gov (United States)

    Venerito, Marino; Vasapolli, Riccardo; Rokkas, Theodoros; Malfertheiner, Peter

    2015-09-01

    Helicobacter pylori infection is the principal trigger of gastric carcinogenesis and gastric cancer (GC) and remains the third leading cause of cancer-related death in both sexes worldwide. In a big Japanese study, the risk of developing GC in patients with peptic ulcer disease who received H. pylori eradication therapy and annual endoscopic surveillance for a mean of 9.9 years was significantly lower after successful eradication therapy compared to the group with persistent infection (0.21%/year and 0.45%/year, respectively, p = .049). According to a recent meta-analysis, H. pylori eradication is insufficient in GC risk reduction in subjects with advanced precancerous conditions (i.e., intestinal metaplasia and dysplasia). A microsimulation model suggested screening smokers over the age of 50 in the U.S. for serum pepsinogens. This would allow to detect advanced gastric atrophy with endoscopic follow-up of subjects testing positive as a cost-effective strategy to reduce GC mortality. In a Taiwanese study, the anti-H. pylori IgG-based test-and-treat program had lower incremental cost-effectiveness ratios than that with (13)C-urea breath test in both sexes to prevent GC whereas expected years of life lost for GC were higher and the incremental cost-effectiveness ratios of test-and-treat programs were more cost-effective in young adults (30-69 years old) than in elders (>70 years old). With respect to gastrointestinal malignancies other than GC, a meta-analysis confirmed the inverse association between H. pylori infection and esophageal adenocarcinoma. In a Finnish study, H. pylori seropositivity was associated with an increased risk of biliary tract cancers (multivariate adjusted OR 2.63; 95% CI: 1.08-6.37), another meta-analysis showed a slightly increased rate of pancreatic cancer in patients with CagA-negative strains (OR: 1.30; 95% CI: 1.02-1.65), whereas current data suggest that the association between H. pylori and colorectal neoplasms may be population

  18. Endoscopic management of gastrointestinal smooth muscle tumor

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Zhou; Nong-Hua Lv; Hong-Xia Chen; Chong-Wen Wang; Xuan Zhu; Ping Xu; You-Xiang Chen

    2007-01-01

    AIM: To systematically evaluate the efficacy and safety of endoscopic resection of gastrointestinal smooth muscle tumors (SMTs, including leiomyoma and leiomyosarcoma) and to review our preliminary experiences on endoscopic diagnosis of gastrointestinal SMTs.METHODS: A total of 69 patients with gastrointestinal SMT underwent routine endoscopy in our department.Endoscopic ultrasonography (EUS) was also performed in 9 cases of gastrointestinal SMT. The sessile submucosal gastrointestinal SMTs with the base smaller than 2 cm in diameter were resected by "pushing" technique or "grasping and pushing" technique while the pedunculated SMTs were resected by polypectomy. For those SMTs originating from muscularis propria or with the base size ≥ 2 cm, ordinary biopsy technique was performed in tumors with ulcers while the "Digging" technique was performed in those without ulcers.RESULTS: 54 cases of leiomyoma and 15 cases of leiomyosarcoma were identified. In them, 19 cases of submucosal leiomyoma were resected by "pushing"technique and 10 cases were removed by "grasping and pushing" technique. Three cases pedunculated submucosal leiomyoma were resected by polypectomy.No severe complications developed during or after the procedure. No recurrence was observed. The diagnostic accuracy of ordinary and the "Digging" biopsy technique was 90.0% and 94.1%, respectively.CONCLUSION: Endoscopic resection is a safe and effective treatment for leiomyomas with the base size ≤2 cm. The "digging" biopsy technique would be a good option for histologic diagnosis of SMTs.

  19. Prevalence of mucocutaneous manifestations in human immunodeficiency infection - learning from a rural centre in Tamilnadu, India

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    Mohankumar Vedhanayagam

    2016-06-01

    Full Text Available Background: Ever since its recognition in 1981, HIV continues to ravage all the continents of the world. HIV infection produces a panorama of mucocutaneous manifestations ranging from the macular rash seen in acute and lsquo;sero conversion' syndrome to extensive end-stage Kaposi's sarcoma. Skin disease may be the first presenting feature of the disease and it raises the suspicion to screen for HIV infection. Disease progression may result in significant morbidity. Methods: This study was undertaken in 116 People living with HIV, who attended the well health clinic in Department of Skin and STD, IRT Perundurai Medical College, Erode, in rural Tamilnadu, from 15th June 2005 to 14th August 2005. The study patients were interviewed after pre and post-test counselling. All the patients underwent a complete physical and genital examination with keen clinical analysis for the mucocutaneous manifestations of HIV infection. Results: 96% of HIV positives in our study had mucocutaneous manifestations. Commonest disease observed was oral candidiasis n=63 (56.25%. Dermatophytosis n=46 (41.07% was the second most common infection followed by papular and follicular eruptions in HIV (n=34, 30.3%. Conclusions: Respiratory system illnesses were the commonest presenting opportunistic illnesses followed by the gastrointestinal tract. [Int J Res Med Sci 2016; 4(6.000: 1959-1965

  20. Mindfulness-Based Therapies in the Treatment of Functional Gastrointestinal Disorders: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Monique Aucoin

    2014-01-01

    Full Text Available Background. Functional gastrointestinal disorders are highly prevalent and standard treatments are often unsatisfactory. Mindfulness-based therapy has shown benefit in conditions including chronic pain, mood, and somatization disorders. Objectives. To assess the quality and effectiveness reported in existing literature, we conducted a meta-analysis of mindfulness-based therapy in functional gastrointestinal disorders. Methods. Pubmed, EBSCO, and Cochrane databases were searched from inception to May 2014. Study inclusion criteria included randomized, controlled studies of adults using mindfulness-based therapy in the treatment of functional gastrointestinal disorders. Study quality was evaluated using the Cochrane risk of bias. Effect sizes were calculated and pooled to achieve a summary effect for the intervention on symptom severity and quality of life. Results. Of 119 records, eight articles, describing seven studies, met inclusion criteria. In six studies, significant improvements were achieved or maintained at the end of intervention or follow-up time points. The studies had an unclear or high risk of bias. Pooled effects were statistically significant for IBS severity (0.59, 95% CI 0.33 to 0.86 and quality of life (0.56, 95% CI 0.47 to 0.79. Conclusion. Studies suggest that mindfulness based interventions may provide benefit in functional gastrointestinal disorders; however, substantial improvements in methodological quality and reporting are needed.