Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003615 (appendicitis)
 4,439 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After reviewing all 123 of these patients, here are some suggestions which may improve the accuracy of diagnosis of appendicitis. 1. Proceed slowly with any patient with equivocal history and physical exam +/- WBC less than 10,000. 2. Seriously consider U.T.I. or other renal pathology in patients with greater than 20 RBC +/or greater than 30 WBC/hfp (w/bacteria) as cause of RLQ pain, rather than appendicitis; i.e. only 1 of 81 patients with appendicitis had a coexistent U.T.I. 3. Be aware that pain starting in the RLQ is less common in appendicitis than in other conditions mimicking appendicitis. 4. Be wary of all women presenting with RLQ pain on days 1 through 10 of their menstrual cycle. 5. Consider a barium swallow or enema study in patients in categories 1-4 above looking for a normally filled appendix while a) observing patient and b) awaiting outstanding lab results (i.e. ur. cult., cerv. os cult., etc.). 6. Follow closely all patients in all of the above categories and operate for worsening condition. 7. Require classic or near classic history and physical findings in patients with WBC less 10,000 suspected of having appendicitis, prior to surgery. Footnotes to these suggestions are as follows: 1. Understand that following these suggestions may result in an increase in the incidence of perforation coincident with an increase in diagnostic accuracy. 2. Be less hesitant to operate on patients over 50 y.o. because of a) their frequent atypical presentations, and b) the known higher incidence of perforation in this age group.(ABSTRACT TRUNCATED AT 250 WORDS)
Ala Med 1989 Oct
PMID:Improving diagnostic accuracy in appendicitis. 261 Jan 91

CFTR, or cystic fibrosis transmembrane conductance regulator, the gene product that is defective in cystic fibrosis, is present in the apical membrane of the epithelial cells from the stomach to the colon. In the foregut, the clinical manifestations are not directly related to the primary defect of the CFTR chloride channel. The most troublesome complaints and symptoms originate from the oesophagus as peptic oesophagitis or oesophageal varices. In the small intestinal wall, the clinical expression of CF depends largely on the decreased secretion of fluid and chloride ions, the increased permeability of the paracellular space between adjacent enterocytes and the sticky mucous cover over the enterocytes. As a rule, the brush border enzyme activities are normal and there is some enhanced active transport as shown for glucose and alanine. The results of continuous enteral feeding of CF patients clearly show that the small intestinal mucosa, in the daily situation, is not functioning at maximal capacity. Although CFTR expression in the colon is lower, the large intestine may be the site of several serious complications such as rectal prolapse, meconium ileus equivalent, intussusception, volvulus and silent appendicitis. In recent years colonic strictures, after the use of high-dose pancreatic enzymes, are being increasingly reported; the condition has recently been called CF fibrosing colonopathy. The CF gastrointestinal content itself differs mainly from the normal condition by the lower acidity in the foregut and the accretion of mucins and proteins, eventually resulting in intestinal obstruction, in the ileum and colon. Better understanding of the CF gastrointestinal phenotype may contribute to improvement of the overall wellbeing of these patients.
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PMID:Gastrointestinal manifestations in cystic fibrosis. 886 67