News - Part 68

Infection of ileum mesothelium: Case presentation (Part 2)

clopidogrelMedications included clopidogrel 75 mg per day, insulin (neutral protamine Hagedorn: 16 U every morning and 14 U every night; Humulin-R [Eli Lilly Canada Inc]: 8 U to 15 U every morning and 8 U to 14 U every night) and losartan 25 mg per day. Her past surgical history was significant for resection of an ovarian fibroma, an iliac vein thrombectomy, caesarian section and appendectomy.

One week before admission, she was diagnosed with bronchitis and treated with an oral antibiotic — buy antibiotics online. She subsequently developed nausea, vomiting, bloating, abdominal distension and tenderness. She was admitted to the surgical unit for a small bowel obstruction that was confirmed radiologically. Read more »

Infection of ileum mesothelium: Case presentation (Part 1)

HSV cytopathic atypia and HSV IHC staining was confined to myofibrocytes and mesothelial cells without involvement of epithelium. HSV was isolated in bronchial secretions postoperatively by direct fluorescence antibodies. To our knowledge, this is the first documentation of the distribution of HSV cytopathic changes in the ileum of a patient with symptomatic disseminated HSV infection complicating type I diabetes. Our case portends that disseminated HSV infection can have a viral cytotropism differing from that of a localized epithelial HSV gastrointestinal tract infection. Read more »

Infection of ileum mesothelium

herpes simplex virusGastrointestinal herpes simplex virus (HSV) infection is predominantly a disease of the esophagus in immunodefi-cient patients. Patients are usually asymptomatic but may experience odynophagia, retrosternal chest pain or fever. Reported cases of disseminated HSV infection in immunocompetent patients are commonly complications of pregnancy . However, rare anecdotal case reports describe HSV viremia, proctocolitis and hemorrhagic cystitis in patients with diabetes mellitus. Read more »

Short questionnaire for use in patients with persistent upper gastrointestinal symptoms (Part 3)

The test has good test-retest reproducibility and responsiveness. In its current form, the PASS questionnaire allows patients to record their current symptoms easily and it facilitates communication with their physicians; the questionnaire also allows physicians to rapidly assess their patients’ symptom status during PPI therapy. As such, it should help physicians to identify patients with upper GI, acid-related problems that require rescue medication or a change in acid suppression therapy, and it may also be helpful in assessing the patients’ response to treatment. Read more »

Short questionnaire for use in patients with persistent upper gastrointestinal symptoms (Part 2)

The PASS questionnaire demonstrated excellent test-retest reliability when comparing questionnaire scores from the baseline visit with those obtained one week later. It also demonstrated good responsiveness in detecting a significant change in health status. Because the PASS test questionnaire was designed to pose a very limited number of questions – each question intended to address an independent aspect of the patient’s symptoms – there was, as expected, low internal consistency and this was confirmed by the G-analysis. Read more »

Short questionnaire for use in patients with persistent upper gastrointestinal symptoms (Part 1)

Proton pump inhibitorThe PASS (Proton pump inhibitor Acid Suppression Symptom) questionnaire was developed using established methodology to address the identified need for a simple clinical tool. The concerns and therapeutic needs of patients with persistent acid-related symptoms despite ongoing PPI therapy were first documented and, based on this, a list of questions was developed to assess content validity in focus groups. Five major areas or domains of interest or concern to patients were identified; therefore, the PASS questionnaire was designed as a short five-question questionnaire. Read more »

Gastric emptying scintigraphy: Conclusions

There was no statistically significant correlation between gastric emptying abnormalities and the duration of the disease or the number of attacks. Also, no difference existed between males and females or among the different types of MS. In agreement with this, Minderhoud et al found that bowel disturbances have no correlation to the age, sex and disease duration in MS patients. Read more »

Gastric emptying scintigraphy: Gastric emptying and the severity of MS

colonic motilityConstipation in MS can result from the absence of normal increment in colonic motility after eating. Chia et al found that paradoxical puborectalis contraction is present in MS patients and can lead to constipation. Other nonneuro-logical factors that contribute to constipation are lack of exercise arising from immobility, inadequate dietary fibre and hydration, and the effects of certain medications such as anticholinergics used to control irritative bladder symptoms and tricyclic antidepressants. Read more »

Gastric emptying scintigraphy: Gastric emptying in lower bowel dysfunction

Our results showed that the mean half-time was longer in patients with constipation, implying a slower rate of gastric emptying. On the other hand, the mean half-time was shorter in patients with fecal incontinence, indicating a faster rate of gastric emptying. Nevertheless, these differences in the rate of gastric emptying between patients with constipation or fecal incontinence and patients without constipation or fecal incontinence was not statistically significant (P=0.197 and P=0.654, respectively). Read more »

Gastric emptying scintigraphy: Prevalence of lower bowel dysfunction (Part 2)

bowel dysfunctionSullivan and Ebers reported that 53% of their patients with MS had constipation, and Minderhoud et al reported that 52.7% of MS patients complained of irregularities in their defecation pattern. Another study of 77 patients with MS found that 52% had bowel dysfunction. Among a group of 209 patients with MS, 41.3% reported bowel dysfunction. Hennessey et al reported that 54% of 221 patients with MS were constipated and 29% suffered from fecal incontinence. Read more »

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