Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the diagnostic, prognostic and therapeutic features of non-Hodgkin's lymphoma in eight patients in whom the disease was seen as a primary tumor of the liver. This series illustrates the variety of situations in which lymphoma might be diagnosed: (a) abdominal pain and hepatomegaly (three cases), (b) incidental finding at evaluation of a patient with cirrhosis (two cases), (c) secondary neoplasm after treatment for Hodgkin's disease (one case) and (d) complication of AIDS (two cases). In most cases, clinical and/or radiological features were nonspecific. However, the combination of the following features must be considered as suggestive: occurrence of an apparently primary hepatic tumor in an immunocompromised patient, absence of the usual serum tumor markers and increased serum lactic dehydrogenase activity. The final diagnosis was based on histological examination of specimens obtained by ultrasonically guided liver biopsies or at surgery. All cases belonged to unfavorable histological subtypes. Immunohistochemical findings on paraffin-embedded sections demonstrated the B-lymphocyte lineage of the seven tumors available for study. In the three patients without coexisting disease, complete remission was obtained by surgery alone or combined with chemotherapy. In the two patients with coexisting cirrhosis, outcome was rapidly unfavorable, with death occurring less than 3 mo after diagnosis. Among the three immunocompromised patients, two experienced a rapid unfavorable outcome, and the remaining one was in complete remission after surgery and chemotherapy. In conclusion, primary non-Hodgkin's lymphoma of the liver arising in patients without coexisting disease has a slow progression and might be successfully treated by surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Non-Hodgkin's lymphoma presenting as a primary tumor of the liver: presentation, diagnosis and outcome in eight patients. 202 91

The epidemiology, pathogenesis, clinical manifestations, and treatment of Mycobacterium avium complex (MAC) infection are reviewed. MAC infection is one of the most common infections in AIDS patients. Its pathogenesis is poorly understood, but it is believed to develop by gastrointestinal colonization followed by systemic invasion. The relatively poor response to treatment may be partly accounted for by the tremendous mycobacterial load present by the time patients develop systemic symptoms. Clinically, MAC infection is difficult to differentiate from the signs and symptoms of AIDS or from other opportunistic infections. Signs and symptoms include fever, malaise, anorexia, night sweats, and weight loss; diarrhea and abdominal pain may also be present. There is no established therapy for MAC infection, although combinations of three to five antimicrobial agents are typically used. There has been consistently poor correlation between in vitro results and in vivo outcomes in the treatment of MAC infection. Currently, the role of treatment is mainly to suppress the progression of infection and to relieve symptoms. Recent in vitro studies and animal studies have revealed possible alternative agents and combinations of agents (e.g., macrolide antibiotics, quinolones, amikacin, cytokines) that may influence therapy of MAC infection. No known therapy for MAC has been shown to prolong survival in AIDS patients, possibly because of the high organism load that exists once patients become symptomatic. Research is needed to find improved methods for earlier detection of MAC infection, determine optimal dosage regimens of current antimycobacterial agents, develop better antimycobacterial drug-delivery systems (e.g., liposomes), and discover new antimicrobials with better activity against MAC and methods of immune modulation that will overcome immune system defects.
 ...
PMID:Current and investigational therapies for AIDS-associated Mycobacterium avium complex disease. 191 27

Seventeen patients with abdominal tuberculosis were recently treated at our institution. Two distinct patient populations were identified--immigrants and individuals infected with the human immunodeficiency virus. Abdominal pain, weight loss and fever were the most common complaints, with abdominal tenderness and pyrexia the most frequent physical findings. Only five of 17 patients had concomitant pulmonary tuberculosis. A typical computed tomographic scan was helpful in the diagnosis. Diagnosis was made at emergency (five patients) or elective (six patients) laparotomy, by endoscopic (two patients) or percutaneous (three patients) biopsy or on the basis of roentgenologic and clinical evidence (one patient). All responded to antituberculous chemotherapy. With the spread of acquired immunodeficiency syndrome (AIDS), tuberculosis has become increasingly frequent in urban areas and it must be suspected in all immigrants and patients with AIDS presenting with abdominal complaints.
 ...
PMID:The reappearance of abdominal tuberculosis. 203 31

These case reports describe two patients with acquired immune deficiency syndrome (AIDS) who presented with acute right lower quadrant pain. Appendiceal involvement with Kaposi's sarcoma accounted for the clinical presentation, and was confirmed histologically. This association emphasizes the diagnostic confusion that may be caused by acute abdominal conditions in the AIDS population. Abdominal pain may result from AIDS-related or unrelated processes; appropriate operative intervention requires recognition of the various diagnostic possibilities.
 ...
PMID:Appendiceal Kaposi's sarcoma: a cause of right lower quadrant pain in the acquired immune deficiency syndrome. 205 37

This article reviews the chemistry, pharmacology, spectrum of activity, pharmacokinetics, clinical efficacy in leprosy and Mycobacterium avium complex (MAC) infection, adverse effects, drug interactions, and special considerations of clofazimine. The drug is active in vivo against M. leprae and in vitro against MAC. In addition, it possesses antiinflammatory and immunosuppressive properties. Clinical studies support the efficacy of clofazimine as a part of multidrug therapy in treating leprosy. It also appears to reduce the incidence and severity of erythema nodosum leprosum reactions that often occur during the treatment of leprosy. Efficacy in treating MAC infection in patients with AIDS is not well documented, despite the use of clofazimine in combination with other agents. A few patients have responded symptomatically and by clearing their mycobacteremia, although there is no evidence that mortality is reduced. Clofazimine is well tolerated, at least when doses less than or equal to 100 mg/d are used. Adverse reactions include discoloration of the skin, self-limiting gastrointestinal intolerance, severe and life-threatening abdominal pain and organ damage due to clofazimine crystal deposition, and asymptomatic discoloration of the eye. Clofazimine should be considered for formulary inclusion.
 ...
PMID:Clofazimine: a review of its use in leprosy and Mycobacterium avium complex infection. 206 38

The protozoon Blastocystis hominis may cause episodes of diarrhoea with abdominal pain, tenesmus, fever and eosinophilia. We have observed 5 cases of blastocystosis in male subjects with symptomatic HIV infection. All patients had a complete response to metronidazole. This report confirms that Blastocystis hominis may be responsible for HIV-related diarrhoea.
Int J STD AIDS 1990 Mar
PMID:Blastocystosis: a new disease in the acquired immunodeficiency syndrome? 209 90

The occurrence of abdominal pain, vomiting, and diarrhea in patients with acquired immune deficiency syndrome has been attributed more frequently to enteropathogen organisms that invade the body in consequence of the immunologic unbalance of the host. Among several causes the cryptosporidiosis has been detected with some prevalence and its predominant localization was gastrointestinal tract, although other extra-intestinal sites have also been reported. In the present case the endoscopic examination established the diagnosis of erosive gastroduodenitis while the histological examination showed the presence of Cryptosporidium sp. in gastric and duodenal biopsy specimens. A proper etiological diagnosis in such cases is important for the choice of therapy.
 ...
PMID:[Erosive gastroduodenitis associated with Cryptosporidium in a patient with acquired immunodeficiency syndrome]. 213 31

In summary, we have described a patient with AIDS and a previously unreported cause of biliary tract obstruction. The incidence of cryptococcal visceral lymphadenitis in patients with AIDS and disseminated cryptococcosis is unknown, but, if present, is probably clinically silent in most instances. However, in the differential diagnosis of abdominal pain and cholestasis in such patients, one should consider major biliary duct obstruction due to cryptococcal lymphadenitis.
 ...
PMID:Biliary obstruction and cholestasis in AIDS: case report. 218 18

Over the next several decades the gastroenterologist practicing anywhere in the world will be confronted with patients with AIDS-related gastrointestinal disorders. Universal body substance isolation precautions should be practiced, however, in dealing with all patients, including those outside traditional 'risk' groups for AIDS. Principal among these precautions are using gloves for personnel involved in procedures and high-level disinfection or sterilization for all endoscopy equipment. Endoscopic procedures should be planned well in advance with special attention to endoscope selection and transport media availability. Organ-associated symptoms are reviewed, especially dysphagia, odynophagia, hemorrhage, diarrhea, and abdominal pain. Opportunistic infections and malignancies often present characteristic endoscopic appearances such as that seen for cytomegalovirus ulceration or Kaposi's sarcoma. AIDS-related biliary disorders should also be recognized, principally sclerosing cholangitic or papillary stenosis.
 ...
PMID:AIDS and the gastroenterologist. 223 76

A review of the discharge diagnoses and mycobacterial cultures of patients admitted to a major New York City hospital over an 18-month period revealed 21 patients with abdominal mycobacterial infections (17 male, 4 female) with an average age of 36 years. Acquired immunodeficiency syndrome (AIDS) or an identifiable AIDS risk was present in 14. The disease was manifest by peritoneal (eight patients), ileocecal (seven), and hepatic involvement (three), and psoas abscess (three). Diffuse abdominal pain was the most frequent presenting symptom. However, absence of pain (19 percent) and lack of abdominal findings (28 percent) were not uncommon. The erythrocyte sedimentation rate was significantly elevated (mean 72 mm/hour), whereas the white blood cell count was normal in 18 patients. Computed tomography findings were abnormal in all patients studied and suggested mycobacterial infection in 67 percent. Ten patients (48 percent) required surgery. Although there were no individual differences in clinical or laboratory presentation between the operative and nonoperative patient groups, more patients with pain and higher fever were operated upon. There was one postoperative death. The overall mortality rate was 24 percent, and the mean survival and follow-up 10.2 months and 12.2 months, respectively.
 ...
PMID:Abdominal mycobacterial infections in immunocompromised patients. 229 89


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>