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

This is a retrospective study of 35 patients with spontaneous bacterial peritonitis and liver cirrhosis identified between 1981 and 1989. The mean age of all patients was 44 years, with a range of 16 to 68. Criteria for spontaneous bacterial peritonitis included either a positive ascites culture with a polymorphonuclear cell concentration greater than 250 cells per mm3 (18 cases) or a negative ascitic fluid culture with a polymorphonuclear cell count greater than 500 cells per mm3 and no evident intra-abdominal source of infection (17 cases). Twenty-one patients were male and 14 female. The most frequent presenting symptoms were abdominal pain and fever, noted in 20 (57%) and 19 (54%) patients, respectively, while 5 patients (14%) were completely asymptomatic. The overall mortality in this series was 54% (19 of 35 patients). The presence of encephalopathy or renal insufficiency was associated with a high mortality rate (73% and 87%, respectively). Encephalopathy was present in 67% of the non-survivors, but in only 25% of the survivors (p < 0.0025); likewise, renal failure was observed in 68% of the non-survivors, but in only 12.5% of those who survived (p < 0.001). The use of newer-generation cephalosporins and penicillins led to a diminished mortality (42%) as compared with that (64%) observed in patients treated with conventional antibiotic regimens.
Hepatogastroenterology 1992 Dec
PMID:Spontaneous bacterial peritonitis in cirrhosis: clinical and laboratory features, survival and prognostic indicators. 148 64

Myotonic dystrophy is an autosomal inherited disorder of both striated and smooth muscle, and is considered to be a rare cause of gastrointestinal dilatation and abnormal peristalsis. We report on a patient with myotonic dystrophy complicated by gastric volvulus. A 57-year-old female with myotonic dystrophy suddenly developed abdominal pain, nausea and vomiting. X-ray examinations revealed gastric dilatation and pyloroantral obstruction, consistent with acute gastric volvulus. The patient underwent successful emergency gastrectomy. Gastric volvulus is often an unrecognized surgical emergency, but its clinical and radiographic features are so characteristic that accurate diagnosis is possible if the condition is kept in mind. Thus, the clinician should consider the possibility of gastric volvulus when evaluating gastrointestinal complaints in patients with myotonic dystrophy.
Hepatogastroenterology 1992 Dec
PMID:Gastric volvulus complicating myotonic dystrophy. 148 75

The irritable bowel syndrome is a common disorder of gastrointestinal motility. Abdominal pain, bloating, and inconsistent bowel habits are the hallmark symptoms of irritable bowel syndrome. Fever, weight loss, and gastrointestinal bleeding often indicate more serious pathologic gastrointestinal conditions, such as inflammatory bowel disease or infectious enteritis. Because irritable bowel syndrome is so prevalent in our society, the primary care physician should be able to readily recognize the clinical features of this disorder in order to spare patients expensive, unnecessary diagnostic and therapeutic interventions. In this review, the authors discuss the clinical and psychological features of irritable bowel syndrome and offer a useful approach to the diagnosis and treatment of this disorder.
J Am Osteopath Assoc 1992 Dec
PMID:Irritable bowel syndrome. 148 81

The safety of intravenous (IV) and oral ondansetron has been evaluated in over 7,000 cancer patients in world-wide clinical trials. In adult patients receiving single-day chemotherapy, the incidence of adverse events was 45% with IV ondansetron (n = 317) and 59% with metoclopramide (n = 279). Headache occurred in 17% of ondansetron patients and 10% of metoclopramide patients, whereas diarrhea symptoms were reported in 15% of the former and 29% of the latter. The incidence and types of adverse events were similar following three 0.15 mg/kg IV ondansetron doses and 8- or 32-mg single IV doses. There was a slight increase in the incidence of headache following a single 32-mg dose (25%) compared with a single 8-mg dose (18%) or three 0.15 mg/kg doses (18%). The safety profile of oral ondansetron was similar to that of the IV formulation. Following an 8-mg oral dose administered three times a day for 3 days, the most frequently reported adverse events were headache (21%), constipation (7%), and abdominal pain (5%). In a group of 209 pediatric patients receiving chemotherapy, the incidence of adverse events following IV and oral ondansetron was 19%. The most commonly reported adverse event was headache (4%). In comparative clinical trials, extrapyramidal symptoms were reported in 5% of the metoclopramide patients but none of the ondansetron patients. In open-label trials, two patients who received ondansetron reported symptoms consistent with, but not diagnostic of, extrapyramidal reactions. The incidence of vascular occlusive events and seizure disorders was identical for ondansetron and comparative agents. Serum transaminase values increased significantly in 6% to 8% of ondansetron patients and 2% of metoclopramide patients who received cisplatin. There was no apparent relationship between the dose of ondansetron administered and the incidence of increased transaminase abnormalities. However, there was an apparent relationship between the dose of cisplatin administered and the incidence of transaminase abnormalities. In patients who received non-cisplatin chemotherapy, there was no difference in serum transaminase values between oral ondansetron and placebo. These data demonstrate that ondansetron is better tolerated than metoclopramide and is safe for IV and oral administration to patients receiving chemotherapy. In addition, ondansetron is well tolerated when administered as a single 32-mg infusion over 15 minutes.
Semin Oncol 1992 Dec
PMID:Clinical safety of ondansetron. 148 79

Patients who continue to have or who develop abdominal pain after apparently successful cholecystectomy pose diagnostic difficulties. This study reports 384 such patients, investigated by endoscopic retrograde cholangiopancreatography (ERCP). There were 146 patients with abdominal pain alone with no previous history of common bile duct (CBD) exploration, of whom only 17 (11.6 per cent) had CBD stones on ERCP. Bile duct calculi were present in 76 of 140 patients (54.3 per cent) with abnormal biochemical findings (raised alkaline phosphatase and/or amylase level) and in 34 of 57 (60 per cent) with an abnormality detected on ultrasonography or intravenous cholangiography. A combination of biochemical and radiological abnormalities was present in 37 patients and was associated with CBD stones in 28 (76 per cent). Patients who had undergone CBD exploration represented a special group, of whom the majority (75 per cent) had common duct stones at ERCP even in the absence of biochemical and radiological abnormalities. ERCP is a useful investigation in patients with persistent postcholecystectomy symptoms. Other features in addition to pain or a history of CBD exploration may be relevant to the decision to perform ERCP in the investigation of these patients.
Br J Surg 1992 Dec
PMID:Role of endoscopic retrograde cholangiopancreatography in the investigation of pain after cholecystectomy. 148 35

Non-specific abdominal pain (NSAP) may have a detectable psychological component that could be used to predict outcome. To test this hypothesis, 131 patients aged 14-40 years admitted with acute abdominal pain were assessed using the General Health Questionnaire (GHQ) and Hospital Anxiety and Depression (HAD) scale, and a structured interview. Of 61 patients with NSAP, more had a psychosocial problem identified by the admitting registrar (P < 0.01) and marginally more had high questionnaire scores. The risk of having NSAP was high if an abnormality on interview accompanied high questionnaire scores (relative risk 1.93 (95 per cent confidence interval (c.i.) 1.35-2.77)) or if prodromal pain had lasted > 7 days (relative risk 2.13 (95 per cent c.i. 1.55-2.92)). After 2 years, patients with continuing pain had higher HAD and Spielberger Anxiety Trait scores (both P < 0.02); NSAP was associated with persisting pain (relative risk 2.22 (95 per cent c.i. 1.10-4.48)). Psychosocial factors are implicated in NSAP and in chronic pain, but the sensitivity and specificity of questionnaire assessment are too low to be useful in diagnosis.
Br J Surg 1992 Dec
PMID:Psychological screening for non-specific abdominal pain. 148 44

Young male rats were orally intubated with podophyllotoxin: Group I, control animals, orally fed with vehicle only; Group II, fed with an initial dose of 5 mg.kg-1 b.w., followed by a daily dose of 1.67 mg.kg-1 b.w. for 7d. Group III, fed with an initial dose of 15 mg.kg-1 b.w., followed by a daily dose of 5 mg.kg-1 b.w. for 7d. All animals were sacrificed 72 h after the last dosing. Histopathological examination revealed dose-related fatty change of the liver, atrophy and degenerative changes of the intestinal epithelial linings and testicular seminiferous tubules. Depletion of the pancreatic acinar cell granules was also apparent in the Group III animals. No pathology, however, was observed in the kidneys. The present study demonstrated for the first time degenerative changes in the liver, intestine, testis, and pancreas of animals ingested podophyllotoxin. These pathological changes correlate well with the clinical signs/symptoms of abnormal liver function, abdominal pain and diarrhea, and reduced serum amylase in humans poisoned by podophyllum. Inhibition of protein synthesis and mitosis (disruption of microtubules) are believed to be the underlying mechanisms of these changes observed in the animals intoxicated by podophyllotoxin.
Biomed Environ Sci 1992 Dec
PMID:Experimental podophyllotoxin (bajiaolian) poisoning: II. Effects on the liver, intestine, kidney, pancreas and testis. 148 23

A 26-year-old male canoeist was referred with a 10-day history of abdominal pain, and a palpable mass in the left upper quadrant. No history of direct trauma was given. He was not taking any medication, and malignancy and inflammatory conditions were considered in the differential diagnosis. Ultrasonographic scan identified a mass originating in the rectus abdominis sheath. Ultrasonographically guided aspiration yielded some partially clotted blood, confirming the clinical diagnosis of rectus sheath haematoma. After conservative treatment, the patient resumed training, and is fully asymptomatic 1 year after discharge.
Br J Sports Med 1992 Dec
PMID:Rectus sheath haematoma in a canoeist. 149 Feb 11

A Japanese woman with severe abdominal pain underwent an emergent exploratory laparotomy. Intraperitoneal bleeding from the uterine serosal surface was observed, and a pathologic examination showed that the bleeding was caused by an exudative hemorrhage from the endometrial tissues in the myometrium close to the uterine serosal surface.
Asia Oceania J Obstet Gynaecol 1992 Dec
PMID:Acute abdomen due to adenomyosis of the uterus: a case report. 149 6

In an open multicenter study [corrected], 112 male patients (mean age 47.1 years) with documented symptomatic chronic bacterial prostatitis were treated with oral temafloxacin 400 mg b.i.d. for 28 days. Urine and prostatic secretions were obtained for culture and susceptibility testing, and clinical signs and symptoms were evaluated at day 14 as well as 5-9 days and 26-30 days post-treatment. The most frequently isolated pretreatment pathogens (n = 97) were 36 strains (38%) of Escherichia coli and 16 strains (17%) of Enterococcus. Clinical success (cure plus improvement) was demonstrated in 74 of 81 (91%) patients at visit 4, 5-9 days post-treatment and at visit 5, 26-30 days post-treatment in 61 of 71 (86%) patients. At visit 4, 94% of patients had eradication of pretreatment pathogens. At visit 5, 92% had continued eradication of their original pathogens. Improvement was observed in the severity of signs and symptoms that existed pretreatment at visit 4 (visit 5): dysuria, 92% (93%); perineal pain, 95% (93%); lower abdominal pain, 93% (100%); lower back pain, 88% (93%); scrotal/penile pain, 91% (83%). Digestive system (6.3%) and nervous system (4.5%) adverse events were observed most frequently. Temafloxacin 400 mg b.i.d. administered orally for 28 days represents a safe and effective treatment for chronic bacterial prostatitis.
Am J Med 1991 Dec 30
PMID:Treatment of chronic bacterial prostatitis with temafloxacin. 166 84


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