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Query: UMLS:C0000737 (abdominal pain)
31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Side effects of octreotide may be local, biochemical, gastroenterological, or endocrinological. Local pain at the injection site occurs frequently, but rarely lasts more than 15 minutes and often resolves with continued therapy and may be improved if the vial is warmed prior to injection. No long-term hematological or biochemical abnormalities have been described. Despite initial diarrhea in some patients, no change in circulating fat-soluble vitamins has been consistently reported. Antibodies to octreotide have been described, but are rare. Abdominal pain or diarrhea can occur at the beginning of therapy. These symptoms rarely persist and are minimal if the injections are timed between meals, but this may increase the incidence of gallstones. Gallstones occur with increased frequency. Gastritis has been described as being an invariable consequence of long-term treatment with octreotide. We have found the incidence to be increased in patients on octreotide, but this is not invariable. Hypoglycemia may be exacerbated in some patients with insulinoma because of glucagon suppression. Small numbers of patients on octreotide for acromegaly have developed hypoglycemic. Conversely, carbohydrate tolerance may temporarily worsen because of insulin suppression and rarely oral hypoglycemia drug therapy may become necessary. Most frequently, carbohydrate tolerance does not deteriorate. In some patients with acromegaly, pituitary tumor size may continue to increase despite continued therapy. Last, there is the theoretical risk of addiction to a compound which may act through opiate receptors and considerably alleviates headache in some patients with pituitary tumor. Overall, despite the multiplicity of theoretical side effects, the majority of patients tolerate octreotide well, with no serious untoward effects.
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PMID:Proceedings of the discussion, "Tolerability and safety of Sandostatin". 151 39

Nausea, vomiting, chronic abdominal pain, and constipation developed in three children with insulin-dependent diabetes mellitus beginning 1 to 7 years after the onset of diabetes. All three had considerable difficulty in achieving satisfactory glycemic control. All had delayed gastric emptying of solids and postprandial antral hypomotility. Diabetic autonomic neuropathy must be considered in the differential diagnosis of gastrointestinal symptoms even in the young diabetic patient.
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PMID:Diabetic gastroparesis due to postprandial antral hypomotility in childhood. 161 77

The aim of the present study was to further elucidate acute and chronic manifestations of Yersinia enterocolitica infection. During the period 1974-83, 458 hospitalized patients were diagnosed by antibody response and/or isolation of the microorganism. 64 patients had suffered from chronic conditions as rheumatic disease, inflammatory bowel disease, hepatitis, nephritis or thyroid disease for some time. Acute hepatic, renal, cardiac, pulmonary, pancreatic or neurologic involvement were observed in a substantial portion of patients; several had multiorgan disease. Acute insulin-dependent diabetes was seen in 2 patients, malignant mesothelioma in 2, and specific lymph node inflammation in 1. The patients were followed for 4-14 years (1987). 36/160 readmitted patients had abdominal pain and 26 had diarrhea; chronic colitis was demonstrated in 4. Some patients developed rheumatic conditions; others developed chronic disease of liver, kidneys, heart, pancreas, thyroid or nervous system. Chronic liver disease, in 22 patients, was correlated with positive tests for antinuclear antibody and rheumatoid factor; and might influence development of malignant disease, and mortality. A variety of acute and chronic clinical pictures may be associated with Y. enterocolitica infection, and further clinical research is required in this field.
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PMID:A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. 176 49

This paper describes the clinical course of a young diabetic primigravida who presented to her physician with vomiting and abdominal pain. Despite the conventional doses of intravenous fluid and insulin that were used to treat her suspected diabetic ketoacidosis, she remained severely acidotic and developed increasing abdominal pain. Two hundred twenty units of regular insulin over a 5-hour period were required to reverse the lipolysis, acidemia, and abdominal pain, which characterized her severe episode of diabetic ketoacidosis. This discussion emphasizes the importance of insulin in the reversal of the hyperglycemia and acidosis that accompany a diabetic crisis. The roles of bicarbonate, phosphorous, magnesium, insulin, potassium, and fluids are discussed along with conditions such as pregnancy, infection, pancreatitis, and abdominal pain, which can complicate the management of diabetic ketoacidosis.
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PMID:Diabetic ketoacidosis and pregnancy. 216 29

Pancreatic exocrine and endocrine function is described in 29 patients with pancreas divisum and upper abdominal pain. The diagnosis was made by endoscopic pancreatography (ERP) after cannulation of the major, as well as the accessory, papilla in all patients. At ERP, six patients had signs of marked and six patients moderate pancreatitis, whereas 17 patients were free from pancreatitis changes. Pancreatitis was found in the dorsal anlage in 12 patients (41%) of whom seven (24%) had similar alterations also in the ventral anlage. Fecal fat excretion was increased in 48% of the patients, and abnormal serum levels of pancreatic enzymes were found in more than one-third. Impaired insulin release was detected in 21% of the 28 patients examined following ingestion of oral glucose. Including an additional patient with manifest diabetes, 24% (7/29) had signs of endocrine insufficiency. The serum-insulin, serum-C-peptide and insulin/glucose pattern following an oral glucose load reflected the degree of severity of pancreatitis changes at ERP. Altogether, 66% of the patients had morphological and/or functional evidence of pancreatic affection.
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PMID:Pancreatic exocrine and endocrine function in patients with pancreas divisum and abdominal pain. 223 Mar 57

Seven young patients presenting with diabetic amyotrophy, unusual at their age, are described. Besides symptoms suggestive of proximal muscle weakness and occasionally of diabetes, all patients were underweight; abdominal pain occurred in all the patients. The diagnosis of amyotrophy was confirmed on electromyography and nerve conduction studies in all patients, and muscle biopsy in two patients. All patients recovered fully on control of diabetes with insulin. Only two episodes of stress induced ketosis were recorded in these 7 patients. These patients were not ketotic though they were severely uncontrolled on omission of insulin. They had normal lipid levels, and had no other complications of diabetes. Pancreatic calculi were found in only one patient. We describe here the clinical profiles of these patients and discuss the possible aetiologies of diabetes and the clinical implications.
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PMID:Amyotrophy in young diabetics: clinical profiles. 239 Dec 99

Acquired factor VIII inhibitor was found in a 69-year-old white male with insulin-dependent diabetes mellitus. He presented with left lower abdominal pain and hematoma after a fall. Preoperative hemostasis studies were normal except for prolonged aPTT. Prolonged aPTT was not corrected by 1:1 mixture with normal fresh plasma and incubation showed further prolongation with time. Factor VIII:c was 3.5%. The inhibitor titer was 7.5 Bethesda units. The possible mechanism causing antibody to factor VIII was postulated to be an autoimmune process and/or increased immunogenicity owing to glycosylation of factor VIII coagulant protein.
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PMID:Factor VIII inhibitor in insulin-dependent diabetes mellitus. 249 61

During treatment of four type-1 diabetics (aged 20-46 years) by continuous subcutaneous insulin infusion (CSII) a leak developed in the system which caused severe ketoacidosis. The gastrointestinal symptoms (nausea, vomiting and abdominal pain) were misdiagnosed by both the patients and their doctors because there was only mild hyperglycaemia. These observations highlight the importance of carefully instructing and supervising patients at the beginning of CSII and point to the need of frequent urine testing by the patients, also for urinary keto bodies.
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PMID:[Diabetic ketoacidosis during insulin pump therapy]. 249 65

A deceased 59-year-old woman with insulin dependent diabetes mellitus complicated by chronic thyroiditis and chronic hepatitis was autopsied. She had had diabetes mellitus since she was 30 years old, and insulin therapy was started at 34 years. Laboratory findings were as follows: s-GOT 85, s-GPT 31, gamma-globulin 2.45 g/dl. Immunological tests were positive for anti-smooth muscle antibody and anti-ENA antibody with high titers of antithyroglobulin and anti-microsome antibodies. HLA analysis revealed the presence of DR-4. The thyroid biopsy specimen showed microscopic features characteristic of chronic thyroiditis at 52 years of age. She had been repeatedly admitted for the control of diabetes mellitus. She was admitted for the 9th time in June, 1987 following complaints of abdominal pain. After admission, her general condition became gradually worse, and she died of peritonitis in September, 1987. Pathological examination of the liver revealed an expansion of fibrous tissue on Glisson's capsule accompanied by lymphocytic infiltration and was diagnosed to be chronic inactive hepatitis. As for the thyroid gland, fibrous tissue replaced an extensive area of the thyroid gland, and normal thyroid tissue was not observed. Lymphocytic infiltration was less in comparison with that in the previous biopsy. As for the pancreas, atrophy of exocrine pancreatic tissue and fibrous change in interstitial tissue was observed. Lymphocytic infiltration was also seen in the interstitial exocrine tissue but not in the islet. Immunohistochemical examination of the islets using anti-insulin, glucagon and somatostatin antibodies by ABC peroxidase method showed the selective disappearance of B cells in the islets. The pathological changes in the thyroid gland, liver and pancreas suggest that autoimmune mechanism may be involved in the pathogenesis of chronic thyroiditis, chronic hepatitis and IDDM with exocrine pancreatic impairment in this case.
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PMID:[An autopsied case of insulin dependent diabetes mellitus complicated by chronic thyroiditis and chronic hepatitis]. 259 7

The chemistry, pharmacology, pharmacokinetics, clinical uses, adverse effects and drug interactions, dosage, availability and cost, and indications for use of octreotide, a new synthetic analogue of the peptide hormone somatostatin (SS), are reviewed. Like SS, octreotide suppresses secretion of pituitary growth hormone (GH) and thyrotropin and decreases release of a variety of pancreatic islet cell hormones including insulin, glucagon, and vasoactive intestinal peptide (VIP). Octreotide also reduces splanchnic blood flow, gastric acid secretion, GI motility, and pancreatic exocrine function and alters the absorption of water, electrolytes, and nutrients from the GI tract. The elimination half-life of i.v. octreotide is 72-98 minutes, compared with 2-3 minutes for i.v. SS. Usual administration of octreotide is by the i.v. or s.c. route. Octreotide has been studied in the treatment of hormone-secreting pituitary tumors and pancreatic islet cell tumors. Octreotide therapy lowers GH secretion and improves clinical symptoms in patients with acromegaly and may suppress clinical symptoms to a greater degree than bromocriptine. Patients with carcinoid syndrome and VIP-secreting tumors (vipomas) have had substantial improvement in clinical symptoms with administration of octreotide. This agent does not appear to be effective in the treatment of nonvariceal upper GI bleeding and acute pancreatitis; its relative usefulness in the treatment of variceal bleeding is not established. Adverse effects associated with octreotide therapy generally have been mild, including pain or burning at the injection site, abdominal pain, and diarrhea. Octreotide has been shown to interfere with absorption of oral cyclosporine. Standard initial therapy is octreotide acetate 50-100 micrograms s.c. every 8-12 hours, with titration based on clinical and biochemical effects. Up to 3000 micrograms/day of octreotide acetate has been administered to patients with acromegaly without serious adverse effect. Octreotide is marketed under the brand name Sandostatin and is available in 1-mL ampuls containing 50, 100, and 500 micrograms of octreotide acetate. Because the conditions for which octreotide appears to be most effective are uncommon, the drug should be considered for addition to the formulary in tertiary-care institutions only; addition of octreotide to the formulary of a community hospital is probably unnecessary. The synthetic analogue octreotide is longer acting and more specific in pharmacologic action than SS.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Octreotide, a new somatostatin analogue. 265 11


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