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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

About two fibroid inflammatory polyps of the stomach and 84 similar cases previously reported in the world literature the authors describe the anatomo-clinical features of this entity. The two sexes are equally affected by such a lesion which occurs with a maximum of frequency during the 6th and the 7th decades. More often an epigastralgia with or without anemia is the main symptom of this polyp which is located in the antral submucosa (95% of the cases). A sessile or pedunculated mass is discovered by gastric endoscopy and may be resected during this investigation. Histologic examination shows a well limited fibroblastic proliferation around vessels and an inflammatory infiltration with a variable density of eosinophilic polynuclear cells. The presence of these elements is not a proof for the allergic nature of the polyp: blood eosinophilia is absent or rare and the serum IgE level is not changed.
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PMID:[Fibro-inflammatory polyps of the stomach. Review of the literature apropos of 2 cases]. 408 16

Two ulcerated, sessile, gastric eosinophilic granulomas, measuring 5 and 10 mm in diameter, were diagnosed by endoscopic polypectomy (accurate prior forceps biopsy had not established accurate diagnosis). The patients, aged 76 and 74 years, had anemia and epigastric pain respectively. None of the usual etiologies (parasitic, chemical, traumatic and ulcerous) were found. Survival, clinical symptoms and location were similar to data reported in the literature, which are briefly reviewed. The value of endoscopic polypectomy is emphasized. With this procedure, pedunculated forms can be treated and sessile forms diagnosed, thus avoiding a useless gastrectomy and its hazards in these elderly patients.
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PMID:[Gastric eosinophilic granuloma : value of endoscopic polypectomy. Apropos of 2 cases]. 631 11

This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by 99mTc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative 99mTc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The enterogastric reflux indices of 10 asymptomatic control patients after Billroth II gastrectomy ranged from 4% to 45%. 99mTc HIDA scintigraphy is useful in evaluating patients before and after bile diversion surgery, and demonstrates the quantitative decrease in enterogastric reflux after such surgery.
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PMID:Quantitative evaluation of bile diversion surgery utilizing 99mTc HIDA scintigraphy. 660 Feb 25

Among the more indicative complications encountered in gastrectomized patients, particularly in those cases where the Billroth II technique is used, bile and/or pancreatic reflux is undoubtedly one of the most important manifestations. The abolition of the "sphincteric" function of the pylorus creates a pathophysiological condition of the above-mentioned type when the surgery is not combined with specific antireflux techniques or when particular situations obtain which make alkaline reflux inevitable. These pathophysiological disorders lead to a "chronic gastritis of the stump", which often exhibits differing symptomatic pictures. There are patients in whom there is no correspondence between the anatomo-pathological and symptomatic pictures and who do not suffer at all, phereas there are others (5-35%) who complain of severe symptoms such as epigastric pain aggravated by ingestion of food, reduction in weight, nausea, bile vomiting and often haemorrhagic stillicide with consequent sideropaenic hypochromic anaemia. Taking the above-mentioned considerations as their starting point, the authors set out to investigate these complications more thoroughly in the pathology of gastrectomized patients by means of the long-term follow-up of such patients coming to them for observation after having been subjected to surgical therapy in the form of Billroth II gastric resection (gastro-enterostomy according to Balfour-Kroenlein, or according to Hofmeister-Fininsterer). The study, which is currently still in progress, involves a thorough clinical examination of the symptoms complained of as well as radiological, gastroscopic, histological and haematochemical investigations. The authors report on their preliminary results.
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PMID:[Alkaline reflux after gastric resection using the Billroth II method]. 668 Aug 88

Leiomyoblastoma of the stomach is exceedingly rare. The authors report the case of a 69-year-old woman who presented with acute epigastric pain, anemia and weight loss. She was found to have a malignant leiomyoblastoma (epithelioid leiomyosarcoma) of the duodenum with lymph-node involvement. The clinical and pathological aspects of leiomyoblastoma of the gastrointestinal tract are reviewed, with emphasis on the distinctive, diagnostic histologic features. To the authors' knowledge, this is only the fourth reported case of leiomyoblastoma of the duodenum and the only case in which the tumour was malignant.
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PMID:Malignant leiomyoblastoma (epithelioid leiomyosarcoma) of the duodenum. 672 79

Gastrectomy was performed in 30 patients with superficial gastric cancer, equivalent to 12 p. cent of cases operated upon for gastric neoplasms since 1970. Presenting signs were epigastralgia in 19 cases (in 12 cases of the ulcer type), external bleeding from the digestive tract in 4 cases, dyspeptic disorders in 2 cases, and anaemia in one patient. The lesion was asymptomatic in 4 cases, while in 3 patients it was detected by endoscopy after polypectomy or for achlorhydria. In one case the lesion was discovered completely fortuitously. Cancer was suspected by the endoscopist from gross pathological findings in 7 of the 30 cases. An adenocarcinoma was diagnosed after biopsy in 26 cases, and suspected in the remaining 4 patients. Sub-total gastrectomy was employed in 27 cases, total gastrectomy in 2 cases, and extension to a total gastrectomy in one patient. Gross pathology showed cancer of type I : 8 cases, type II (IIa : 1, IIb : 0, IIc : 10) : 11 cases, type III : 6 cases, and mixed types IIc + III : 5 cases. The submucosa was invaded 17 times, the other 13 lesions involving the mucosa only. There were no immediate postoperative deaths. Three patients were not seen again, while 7 died from secondary causes : 5 for reasons unrelated to their cancer and 2 from unknown causes. By applying strict attention to surgical procedures and precise examination of histological data it should be possible to obtain postoperative survivals comparable to those of Japanese series (80 to 90 p. cent at 5 years, 70 p. cent at 10 years).
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PMID:[Superficial gastric cancer. Results of surgery in 30 cases (author's transl)]. 706 6

The authors analyse the incidence of myoid tumours of the stomach in comparison to bowl cancer as a whole and identify the different anatomopathological varieties (benign leiomyoma, leiomyosarcoma and Martin-Stout's bizarre leiomyoma). Symptoms are usually subtle and development slow: important factors are the site of onset (antro-pyloric in 60% of cases, body 25% and cardias 15%), the type of tumour growth (intra- or extraluminal or mixed) and tumour size which may sometimes be considerable. Four categories of patients are identified on the basis of symptoms shown: a) asymptomatic (chance diagnosis), b) aspecific (vague symptoms such as epigastralgia, dyspepsia, ecc.), c) symptomatic (presence of abdominal mass, chronic anemia, ecc.), d) complicated (onset of complications the most frequent of which is acute hemorrhage). The clinical data reported here refers to 4 patients (3 males and 1 female) aged between 53 and 75 years old. In one case diagnosis was made by chance, in 2 cases diagnosis followed acute hemorrhage of the upper digestive tract, and in the case of the woman clinical controls began following the finding of a voluminous abdominal mass. Diagnosis was based on traditional radiology and EGDscopy, as well as ultrasonography and CT. Treatment was surgical in all cases (two enucleations of the lesion and two atypical gastric resections). In the light of the authors' personal experience and data reported in the literature, the discussion focuses attention on the problems of diagnosis and therapy, in particular the various options facing the surgeon in the form of operating tactics.
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PMID:[Myoid tumors of the stomach. Our experience]. 829 Jan 54

Bleeding pseudocysts respectively pseudoaneurysms represents a seldom complication of chronic pancreatitis in owing to erosion of pancreatic or peripancreatic arteries. The potential rupture into neighbouring organs or in the peritoneal cavity is accompanied with paramount life-threatening risks. During the last years we observed 3 patients with acute intestinal bleeding caused by pseudocysts converted to pseudoaneurysms. The goal of our report is to analyze the diagnostic tools and the management of patients with bleeding pancreatic pseudocysts, also well establish the clinical constellation, which is typical for this complication, the best diagnostic tool and the modalities to immediate control of the acute bleeding situation. All three patients suffered from chronic pancreatitis and alcohol abuse. The first patient had a known pancreatic pseudocyst, which penetrated through the gastric wall and caused a life-threatening bleeding. The second patient was admitted in owing to melena. The examinations yielded a pancreatic pseudocyst with hematosuccus pancreatis. The third patient suffered from abdominal pain and vertigo caused by anemia. With endoscopy, Cat and celiacography a pancreatic pseudocyst with cysto-colic fistula has been identified. The color-doppler ultrasound revealed a pseudoaneurysm supplied from a splenic artery branch. With management of these patients with hemorrhagic complications of pancreatic pseudocysts we acquired the following findings: 1. Patients with known chronic pancreatitis and abdominal tumor, especially when accompanied by epigastric pain and anemia, are highly suspicious for pancreatic pseudoaneurysms. 2. The color-doppler ultrasound is the best diagnostic tool, since this investigation can establish the pseudoaneurysm and identify the source.
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PMID:[Hemorrhage from pseudocysts caused by pseudoaneurysms in chronic pancreatitis. Diagnosis and management]. 837 41

A prospective, controlled, double-blind, double-dummy, multicenter clinical trial was made to assess the efficacy and tolerability of iron-protein-succinylate (ITF 282) in comparison with a well known iron preparation in the treatment of iron deficiency or iron deficient anemia. One thousand and ninety-five patients affected with iron deficiency or overt iron deficient anemia were randomized to receive either two ITF 282 tablets/day (60 mg iron each) or a commercially available ferrous sulphate controlled release tablet (one tablet containing 105 mg iron/day). Five hundred and forty-nine patients received ITF 282; 546 patients were treated with ferrous sulphate. Both treatments lasted 60 days. The treatment outcome was checked by evaluating special hematology, symptomatology, safety hematology and hematochemistry. After two months of treatment, the normalization of the main hematologic parameters in both groups was detected. Although in the first month the reference treatment appears to provide somewhat faster results, at the end of the observation, the values of hematocrit, hemoglobin and ferritin were greater in the ITF 282 group, indicating a more progressive and steady therapeutic effect. The overall clinical rating was significantly in favor of ITF 282, with 78.9% of favorable results vs 67.6%. By dividing the patient population according to pathological conditions (iron deficiency or overt anemia), or according to the etiopathogenesis of the iron deficiency (increased requirement, or increased loss in adults and in the elderly), separate analyses on the treatment outcome were made (and have been included). The general tolerability, although favorable with both treatments, was significantly more favorable with ITF 282. With this medication, 63 patients (11.5%) complained of 69 adverse reactions (25 heartburn, 19 constipation, 25 abdominal pain) vs 141 events reported by 127 patients (26.3%) with the reference medication (33 heartburn, 31 epigastric pain, 23 constipation, 32 abdominal pain, 8 skin rash, 14 nausea). These observations confirm that, although the most modern preparations of ferrous sulphate exhibit a relatively low frequency of adverse events of limited clinical concern, it is nevertheless possible to decrease both the prevalence and the duration of such events without prejudice for the clinical efficacy, with the use of more "physiological" preparations in which the iron is reversibly bound to a protein carrier, thus effectively removing one of the main obstacles to the correct compliance with treatments that must be administered for prolonged periods of time.
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PMID:Iron protein succinylate in the treatment of iron deficiency: controlled, double-blind, multicenter clinical trial on over 1,000 patients. 846 8

A total of 502 children up to the age of 14 years were treated for iron deficiency or overt anemia. ITF 282 was prescribed to 256 children, and a commercially available ferrous polystyrene sulphonate preparation to 246, in a randomized double-blind, double-dummy, ten-center trial. One oral vial of ITF 282 (60 mg iron) was administered once a day to children weighing up to 40 kg; and twice a day to children with body weight equal or superior to 40 kg. In the reference group, oral vials of polystyrene sulphonate (52.5 mg iron) were administered once a day to children weighing up to 40 kg, and twice a day to children weighing 40 kg or more. Treatments lasted 60 days. The treatments' efficacy and tolerability were evaluated taking into consideration: special hematology, symptomatology, safety hematology and hematochemistry, urinalysis. At the end of treatment, the trend was detected to the normalization of the main hematologic parameters in both groups (hemoglobin, hematocrit, ferritin, blood iron, transferrin saturation, MCHC). Although in the first month the reference treatment appears to provide somewhat faster results, significantly greater values of blood iron are observed at the end of the observation in the ITF 282 group, indicating a more progressive and steady therapeutic effect. The overall clinical rating was, although not significant, in favor of ITF 282, with a failure rate of 18.0 vs 24.0%. The general tolerance, although favorable with both treatments, was significantly more favorable with ITF 282. With this medication, 13 patients complained of 13 events (1 heartburn, 6 constipation, 6 abdominal pain) vs 48 events reported by 43 patients with the reference medication (1 heartburn, 2 epigastric pain, 14 constipation, 14 abdominal pain, 3 skin rash, 14 vomiting). These observations confirm that, although the most modern preparations of ferrous ions exhibit a relatively low frequency of adverse events of limited clinical concern, it is nevertheless possible to decrease (with the use of more "physiologic" preparations in which the iron is reversibly bound to a protein carrier) the prevalence and, tendentially, duration and intensity of such events without prejudice for the clinical efficacy. Therefore, the good clinical tolerability of ITF 282 effectively removed one of the main obstacles to the correct compliance with iron treatments (necessarily to be taken long-term), as reduced the risks of undesired events in a particularly susceptible population subgroup, such as children.
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PMID:Controlled, double-blind, multicenter clinical trial of iron protein succinylate in the treatment of iron deficiency in children. 850 Sep 17


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