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

Information about epidemiology, natural history and prognostic factors of adrenocortical carcinoma in Italy is extremely scarce. We report here 35 patients of adult age who were referred to our institution in the last two decades. Nine patients had non functioning, and 26 had functioning tumors. In non-functional tumors initial symptoms were abdominal pain in 90% of cases, fever, weakness, malaise, weight loss in 30%. Only one patient was asymptomatic. Of patients with functioning tumors, 18 presented with Cushing's syndrome, 6 with Cushing's syndrome and virilization, 1 with Cushing's syndrome and feminilization and 1 with hyperaldosteronism. Twenty-two of all cases (63%) had metastases at diagnosis; most frequent sites were lung, liver and distant lymph nodes. The results of tumor staging, according to MacFarlane system, were: stage I, 1 patient (3%); stage II, 10 patients (28%); stage III-IV, 24 patients (69%). Twenty-six out of 35 patients underwent removal of the mass with complete adrenalectomy. Twelve patients received mitotane alone; 8 mitotane and chemotherapy; 5 chemotherapy alone; 2 radiotherapy associated with mitotane or chemotherapy; 1 anthalgic radiotherapy. Survival time ranged from 1 to 108 months. One-year survival rate was 60%, and 5-year survival rate was 10%. Lower survival rate compared with that reported from other countries is probably related to the referring of patients at very advanced stages of disease. Early recognition and referral, in addition to optimization of therapeutic protocols by multicenter studies, may improve prognostic aspects.
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PMID:Adrenocortical carcinoma: epidemiology and natural history. 765 Dec 87

The clinical picture of lead neuropathy was classically described as a painless progressive motor neuropathy with axonal loss. The literature review fails to demonstrate a consensus on the site of axonal loss. This is an EMG report of a patient who developed a late lead neuropathy after a shotgun injury. A 69-year-old Filipino, healthy, male nondrinker sustained a shotgun injury to his left elbow. Nineteen years later he developed abdominal pain, followed by generalized weakness, distal greater than proximal in the extremities, and impaired pin-prick, proprioception, and two-point discrimination. He became nonambulatory and totally dependent in daily activities. He was lost to follow-up for 2 years until January 1993 when he presented with a blood lead level of 84 micrograms/dL. EMG examination revealed a sensorimotor peripheral polyneuropathy with severe axonal loss. This case demonstrates that axonal loss is the predominant feature in lead neuropathy and the location of pathology is in the peripheral nerves.
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PMID:An EMG case report of lead neuropathy 19 years after a shotgun injury. 787 Jan 11

The usual complication of abdominal aortic aneurysms is rupture. Although thrombosis of peripheral aneurysms is common, thrombosis of abdominal aortic aneurysms is rare. Sudden thrombosis of abdominal aortic aneurysms constitutes a surgical emergency, with a mortality of 50 percent. The patient often presents with cool and mottled skin, and with severe pain from the umbilicus to the lower extremities. Femoral pulses are rarely present, and neurologic deficits below the level of occlusion are common. We reviewed four recent patients with thrombosed abdominal aortic aneurysms. They presented with a range of symptoms that included impotence, abdominal pain, lower extremity pain, coolness, and weakness. Angiography in three of the patients revealed complete occlusion of the aorta. The fourth patient did not undergo angiography because of hemodynamic instability. Three of the four patients underwent thrombectomy, aneurysmectomy, and bypass grafting. The other patient underwent axillofemoral bypass grafting in lieu of aneurysmectomy because of severe coronary arteriosclerotic heart disease. All patients did well postoperatively. Our limited experience suggests that prompt diagnosis and surgical management of patients with thrombosed aortic aneurysms can lead to a successful outcome.
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PMID:Thrombosis of abdominal aortic aneurysms. 794 47

A 23-year-old man with epilepsy and a past history of abdominal pain and ileus, developed hypertension and arm and bulbar weakness when valproic acid and carbamazepine were reinitiated. Electrophysiologic studies demonstrated a peripheral neuropathy with features of axonal degeneration and demyelination. Axonal degeneration was documented by sural nerve biopsy. Markedly elevated urinary delta-aminolevulinic acid and porphobilinogen indicated a diagnosis of acute porphyria. Other laboratory studies were most consistent with hereditary coproporphyria. Motor function improved considerably but incompletely over 1 year. An acute, primarily motor neuropathy can occur in several forms of porphyria, including acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria, sometimes even in the absence of concomitant gastrointestinal symptoms.
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PMID:Acute peripheral neuropathy due to hereditary coproporphyria. 800 8

A dog being treated with meglumine antimonate for leishmaniasis was examined because of anorexia, vomiting, diarrhea, weakness, and signs of abdominal discomfort. The history, physical examination findings, clinicopathologic abnormalities, and results of coagulation testing were compatible with a diagnosis of renal failure and disseminated intravascular coagulation. The signs of abdominal pain were most likely a result of microcirculatory obstruction. The cause of disseminated intravascular coagulation in this dog was not determined; however, visceral leishmaniasis could have been associated.
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PMID:Visceral leishmaniasis and disseminated intravascular coagulation in a dog. 804 4

Pneumatosis cystoides intestinalis (PCI) is an uncommon disorder usually associated with intestinal and pulmonary obstructive diseases, recent abdominal procedures and systemic illnesses. PCI has been reported in patients with systemic lupus erythematosus associated with intestinal vasculitis. We describe herein a patient with a month history of intermittent abdominal pain, diarrhoea, hyporexia, and weight loss who underwent intestinal resection for acute abdomen. Post-operatively she gave a three-month history of arthritis of the right knee, ankles and feet, arthralgia of the wrists, MCPs and shoulders. She also described weakness, weight loss, Raynaud's phenomenon, and a skin rash. Laboratory examination revealed an increased ESR, low haemoglobin and haematocrit, positive rheumatoid factor, a positive ANA with a speckled pattern, as well antibodies to DNA, SS-A and cardiolipin. The abdominal symptomatology especially pain, cramps and bouts of diarrhoea persisted after the surgery and became worse two months later. Abdominal X-ray showed distention of bowel with cyst formation in the wall of the entire colon. A diagnosis of PCI was made radiologically. The intestinal pathology was reviewed and vasculitis was identified. The patient received treatment with high dose prednisone with an excellent response; prednisone was progressively tapered and she has been asymptomatic without abdominal complaints or other symptoms for over a year.
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PMID:Pneumatosis cystoides intestinalis in systemic lupus erythematosus with intestinal vasculitis: treatment with high dose prednisone. 808 81

Of 144 consecutive women who requested 1st trimester induced abortion at the Family Planning Association of Hong Kong, 99 (68.7%) chose a medical method consisting of RU-486 (mifepristone) combined with ONO 802 (gemeprost) and 45 (31.3%) chose the surgical method of suction evacuation. The study intended to define the profile of women who would accept the RU-486 tablets on day 1, and then on day 3, ONO 802 pessaries were inserted during 6 hours of hospitalization. Follow-up days were 15 and 43 from the day RU-486 was taken. The median age of the medical group was 29 years vs. 33 years for the surgical group. 91% of women in the surgical group were married compared with 67% in the medical group. Significantly more nulliparous women (40%) and single women below the age of 30 years preferred the medical method. The condom was used more often in the medical group (61%), while oral contraceptive pills were used by 55% of women in the surgical group. Significantly more women in the medical group preferred medication to surgery. On day 3, 88 women reported headache, tenderness of breasts, sleep disturbance, palpitation, and weakness, however, only 5 women had intolerable symptoms, and 1 woman was hospitalized because of severe abdominal pain. On day 3, 67 (68%) of women said they were not worried because their abortion had not yet occurred, while 32 women (32%) were worried because they were skeptical about the efficacy of the drug. Comments on days 8, 15, and 43 indicated that 80 women would choose medical abortion again including 4 women who had to undergo suction evacuation because of failed medical abortion. 12 women required subsequent suction evacuation because of incomplete or missed abortion. Single, young, nulliparous Chinese working women are likely to accept RU-486 and ONO 802.
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PMID:Further acceptability evaluation of RU486 and ONO 802 as abortifacient agents in a Chinese population. 822 56

Protoporphyria is a genetic disorder characterized by a defect in the enzyme ferrochelatase, which catalyzes the chelation of iron to protoporphyrin. This causes excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Progressive and fatal liver disease occurs in a small percentage of cases. We report our experience with eight patients with end-stage protoporphyric liver disease in whom a syndrome developed before transplantation that resembled the neurological crises of the acute porphyrias. This syndrome was characterized by abdominal pain, hypertension, tachycardia, extremity pain and weakness, constipation and nausea and vomiting. Erythrocyte and serum protoporphyrin levels were markedly increased in all patients. In one patient, profound hemolysis developed during the anhepatic phase of transplantation and continued over a period of 72 hr, causing an extreme increase in the serum protoporphyrin level. Progressive weakness deteriorated to paralysis in this patient. This phenomenon suggests that protoporphyrin may gain access to neural tissue when serum levels are markedly increased, causing neurotoxicity.
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PMID:Evidence for neurological dysfunction in end-stage protoporphyric liver disease. 798 71

We describe the clinicopathologic features of 10 patients with recurrent unexplained flushing. These patients were referred to the National Institutes of Health with a diagnosis of mastocytosis or idiopathic anaphylaxis. Both diagnoses were eliminated after evaluation. Patients reported attacks of flushing lasting 15 minutes to 2 days and associated with such symptoms as anxiety, chest tightness, paresthesia, slurred speech, weakness, and pruritus. Abdominal pain was a constant feature, often associated with cramping and an increase in stool frequency. Attacks witnessed by physicians consisted of an exaggerated blush response of the face and upper part of the chest, and were sometimes associated with tachycardia, mild hypertension, and tachypnea. Hives, angioedema, wheezing, and hypotension were not observed. Routine laboratory studies and 5-hydroxyindoleacetic acid, vanillylmandelic acid, and plasma histamine levels were normal. Plasma histamine levels did not elevate during attacks. When performed, results of bone marrow examinations, skin biopsies, and bone scans were normal. Psychiatric examinations frequently revealed somatization disorders. Patients had often been prescribed a wide variety of medications including antihistamines, nonsteroidal anti-inflammatory drugs, and steroids, with little or no benefit. Despite the benign nature of the clinical and laboratory findings, patients had undergone repeated, often invasive, examinations for several years. Whether such patients have a prominent flush response exaggerated through a somatization disorder or a relatively benign flushing disorder associated with putative mediator release remains to be determined. Recognition of this category of patients with unexplained flushing will avoid subjecting such patients to unwarranted repeated examinations, procedures, and inappropriate therapy.
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PMID:A clinicopathologic study of ten patients with recurrent unexplained flushing. 830 82

The frequency and severity of physical and emotional menstrual symptoms were investigated with a cross-sectional study of 502 women not seeking treatment for menstrual symptoms. The most frequent symptoms were abdominal bloating, backache, headache, constipation, low abdominal pain, fatigue and symptoms related to depression. Some symptoms increased during the late luteal phase, and others were related to the women's life-style. Lack of schooling and living in rural areas were associated with headache, backache, sadness, insecurity, restlessness and weakness. Women from urban areas with more schooling had more breast tenderness, abdominal pain, irritability, depression, aggressiveness and increased sexual desire. Younger women had increased appetite, lack of concentration, insecurity, desire to be alone, weakness and dissatisfaction with their looks. Heavier women had more leg cramps, swollen feet, lack of coordination and polydipsia. Menstrual symptoms seem to be determined by the interplay of the menstrual cycle with biologic factors and life-style.
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PMID:Association of physical and emotional symptoms with the menstrual cycle and life-style. 833 24


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