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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hereditary pancreatitis (HP) is a rare cause of chronic pancreatitis. Recurrent abdominal pain is the most common clinical manifestation, with onset in childhood or adolescence. PURPOSE--Report of a case of HP with atypical presentation and a review of the literature. METHODS--A non-alcoholic patient, without history of abdominal pain, with steatorrhea and malnutrition was investigated. The diagnostic evaluation revealed severe chronic pancreatitis. Two close relatives with early onset calcifying pancreatitis were detected. Epidemiologic and clinical features of HP were reviewed. CONCLUSION--Although uncommon, HP should be regarded in the differential diagnosis of chronic pancreatitis. Familial screening of suspected cases should be routinely performed.
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PMID:[Hereditary pancreatitis]. 763 5

The bacterial overgrowth syndrome occurs when there are alterations in intestinal anatomy, gastrointestinal motility, or a lack of gastric acid secretion. Clinically, patients present with nonspecific gastrointestinal symptoms that include abdominal pain, bloating, excessive gas production, diarrhea, weight loss, and malabsorption. The nutritional consequences of intestinal bacterial overgrowth include vitamin deficiencies, fat malabsorption, and malnutrition. The diagnosis requires a high index of clinical suspicion and can be established by specialized testing, such as the 1-gram 14C-xylose breath test. The goal of treatment is eradication of the bacterial overgrowth (usually with antibiotics) and the correction of nutritional deficiencies.
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PMID:Nutritional consequences of intestinal bacterial overgrowth. 780 70

A health profile was obtained in Nigeria of the remote rural villages of Sina Mala and She (1 km away), which have a combined population of 368. The profile was drawn from observation of village facilities, informal interviews with villagers, structured interviews with the village head and his wives, and a simple examination to detect anemia in women and malnutrition in children. It was found that the villages were a 5 km walk or donkey ride over the mountains from the nearest mud road. They had a church and weekly market but no school or grinding machine. Traditional midwives, herbalists, and untrained sellers of medicines were available, and the nearest health facility (providing basic medicines and vaccinations once a month) was 5 km away. Sina Mala was composed of 44 compounds, and She had 13 grouped compounds. Water was obtained from different sources in the rainy and wet seasons. Sanitation was minimal (there were no pit latrines), and an unhygienic local beer was universally consumed. While only 3% of the compounds had floors swept clean of animal feces, water was stored satisfactorily in 82%, and the cooking areas were kept clean in 51%. The birth rate was estimated at 49/1000 population, and the crude death rate was 22/1000. During the 2-week survey, 49% of the population complained of illness (abdominal pain, scabies, respiratory infection, bloody stool, muscle strain, fever, and diarrhea). Diarrhea in children was so common it was not reported as an illness. 75% of those who were ill sought no treatment. All of the adults interviewed were illiterate. 14% of the women were anemic, and 13% had received prenatal care at a hospital 10 km away. Only 10% of the children had received one or more vaccinations, 29% had diarrhea at the time of the survey, 27% were malnourished, and 3% were severely malnourished. None of the children went to school. It was concluded that this isolated community needed schooling and health education, external assistance in the location and drilling of wells, and outreach monthly medical care. In addition, traditional midwives needed training in hygienic methods of delivery and care of the umbilical cord to prevent neonatal tetanus.
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PMID:Village health survey of Sina Mala, Gongola State, Nigeria. 783 10

Brown bowel syndrome is a rare intestinal disorder associated with the deposition of lipofuscin pigment in the smooth muscle cells. We report two such cases presenting with intestinal pseudo-obstruction, abdominal pain, and body weight loss. Both cases had malabsorption and fatty liver. Exploratory laparotomy revealed brownish discoloration of the small bowel wall and enlargement of mesenteric lymph nodes. Light microscopy, autofluorescence and ultrastructure studies confirmed the deposition of lipofuscin pigments in the intestinal muscle cells and reticuloendothelial cells of mesenteric lymph nodes. In addition, the calf muscle biopsy of case 1 displayed myopathy and fatty replacement. Skeletal muscle strength of both patients was partially restored after parenteral and oral vitamin E supplement and other conservative treatment, but gastrointestinal symptoms of both patients continued to deteriorate. Thus, brown bowel syndrome associated with prolonged and severe malnutrition and possibly vitamin E deficiency appears only partially responsive to vitamin E supplementation.
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PMID:Brown bowel syndrome: report of two cases. 791 59

Bacteremia during infection with Shigella is relatively rare and usually self-limited. Bacteremia during shigellosis bearing a high fatality rate has been reported in young infants and in persons with malnutrition or with the acquired immunodeficiency syndrome. We report a case of Shigella sonnei septicemia in a severely neutropenic patient who had fever, abdominal pain, diarrhea, malnutrition, and dehydration. She died after five days despite intensive care. We emphasize that Shigella should be considered among the possible pathogens causing sepsis in neutropenic patients.
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PMID:Fatal Shigella sepsis in a neutropenic patient. 796 32

We studies 151 case of diabetes in the young (age at first visit < or = 35 yrs) from January 1982 to June 1990. We classified the 151 cases into non-insulin dependent diabetes mellitus (NIDDM) (38.4%), malnutrition-related diabetes mellitus (MRDM) (36.4%), insulin-dependent diabetes mellitus (IDDM) (9.9%), secondary diabetes mellitus (2.6%) and unclassified category (12.6%). MRDM can be further classified into 2 groups: 22.5 per cent were fibrocalculous pancreatic diabetes (FCPD) and 13.9 per cent were protein deficient pancreatic diabetes (PDPD). Abdominal roentgenography were performed in 103 cases (68.2%) and pancreatic calcification were found in 34/103 (33%). Farming occupation (p = 0.001), abdominal pain (p = 0.005), male sex (p = 0.0015) and cataracts (p = 0.02) were statistically more common in MRDM comparing to NIDDM and IDDM taken together. There were no statistically significant differences in history of alcohol consumption and raw cassava intake between both groups. Family history of diabetes mellitus were more common in NIDDM comparing to IDDM and MRDM.
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PMID:Diabetes mellitus in the young in Srinagarind Hospital. 800 54

There are increasing challenges for the practising gastroenterologist in treating AIDS-related gastrointestinal diseases. The differential diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, non-specific aphthous ulceration and non-AIDS oesophageal diseases, especially reflux oesophagitis. Chronic subacute abdominal pain with nausea, vomiting, early satiety and weight loss is suggestive of an obstructive lesion caused by lymphoma or Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis or intestinal perforation due to cytomegalovirus. Right upper quadrant pain (with or without fever, vomiting or abnormal liver function tests with a cholestatic profile) is suggestive of hepatobiliary pathology including cholecystitis, cholangitis, acalculous cholecystitis and AIDS cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare, Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni), and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition and weight loss can shorten the life-span of patients with AIDS. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting.
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PMID:AIDS and the gut. 805 32

We have conducted a field study in India in the state of Kerala involving 28,567 inhabitants to determine the prevalence and clinical features of chronic pancreatitis of the tropics (CPT), an illness that is endemic in several regions of India. Selection criteria for the present study included: 1. Characteristic abdominal pain; 2. Evidence of diabetes mellitus; and 3. Evidence of malnutrition/malabsorption. A diagnosis of chronic calcific pancreatitis (CCP) was established by evidence of either 1, 2, or 3 plus X-ray evidence of pancreatic calculi. Diagnosis of noncalcifying chronic pancreatitis (NCCP) was established by 1, 2, or 3 plus an abnormal ultrasound of the pancreas and an abnormal bentiromide test. CPT was discovered among 36 individuals (prevalence 1:793). Strict entry criteria may have excluded additional cases. CPT was far advanced at the time of diagnosis in that 28 had evidence of calcification, 19 had diabetes mellitus, and 27 had an abnormal bentiromide test. The major differences from previous hospital-based studies were female predominance (male/female ratio, 1:1.8), onset of disease at an older age (mean 23.9 yr), and evidence of milder disease. We conclude that previous hospital-based reports that CPT is a severe illness with a male predominance may reflect greater access of seriously ill individuals in general and males in particular to medical care.
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PMID:Prevalence and clinical features of chronic pancreatitis in southern India. 819 40

Anorexia nervosa is considered one type of eating disorder that may result in severe malnutrition. Patients with this disorder commonly complain of postprandial nausea, abdominal pain, and distension. We describe the radiologic and motility abnormalities associated with anorexia nervosa in a 21-year-old female. Barium gastrointestinal series demonstrated marked dilation of the duodenum, with prolongation of intestinal transit. A 4-hr fasting gastroduodenal motility study showed no propagating migrating motor complexes (MMC). Prolonged, but nonpropagating, bursts of high-amplitude phasic and tonic contractions were seen in the duodenum. In contrast, antral contractions were of low amplitude and esophageal motor function was normal. Metoclopramide and edrophonium caused an increase in gastroduodenal motor activity, but increased contractions were not associated with symptoms. Following a renutrition program that raised the patient's weight from 64 to 80% of her ideal body weight, the radiographic abnormalities and gastrointestinal dysmotility resolved completely. These observations suggest that anorexia-associated gastrointestinal motor dysfunctions are a consequence, not the cause of the generalized protein-calorie malnutrition associated with anorexia nervosa. The facts that motility in different parts of the gut is affected to different degrees and that gastric and duodenal muscle responds normally to exogenous stimulation argue against a generalized myogenic dysfunction and, rather, point to a reversible dysfunction of neural regulation.
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PMID:Reversal of megaduodenum and duodenal dysmotility associated with improvement in nutritional status in primary anorexia nervosa. 831 30

Stool samples of 1488 children suffering from acute diarrhoea were studied for bacterial culture and sensitivity. Shigella culture was positive in 143 (10 per cent) children and 53 hospitalized children could be studied in detail. Thirty-six (68 per cent) children were under 2 years of age and peak prevalence was observed in summer months. Fever and diarrhoea were universal features; 96 per cent had blood and mucus in the stools, but 32 per cent started with watery diarrhoea lasting 1-3 days followed by dysentery. Two cases (4 per cent) had watery diarrhoea. Abdominal pain dehydration, and malnutrition were present in more than two-thirds of the cases. Central nervous systemic (CNS) manifestations, renal failure, respiratory manifestations, and subacute intestinal obstruction were seen in 45, 25, 17, and 5 per cent of cases, respectively. Shigella dysenteriae was the commonest organism grown in 57 per cent, followed by Shigella flexneri in 36 per cent, Shigella boydii in 4 per cent, and Shigella sonnei in 4 per cent cases. In the majority, the organisms were sensitive to neomycin (83 per cent), furazolidine (86 per cent), and cephaloridine (87 per cent), whereas Shigella strains were resistant to tetracycline in 93 per cent, ampicillin in 83 per cent, chloramphenicol in 91 per cent and cotrimoxazole in 66 per cent cases. Proctosigmoidoscopy was useful in defining the nature of mucosal lesion, to collect swabs for culture and biopsy specimen for histopathology. Four (8 per cent) cases had pseudomembrane and in two cases Clostridium difficile could be identified. Eight (15 per cent) cases died and two of them had shigellaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Shigellosis in children from north India: a clinicopathological study. 853 Dec 65


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