Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Signet-ring cell type of gastric carcinoma can easily escape detection by the pathologist, and this confusion is compounded by the presence of morphologic patterns other than the conventional appearance. One such morphologic variant is composed of deeply eosinophilic cells containing minute cytoplasmic granules with neutral mucin. With this morphology, epithelioid gastrointestinal stromal tumor (GIST), and hepatoid and rhabdoid variants of adenocarcinoma enter the list of diagnostic possibilities, and accurate diagnosis is essential for therapeutic and prognostic considerations. We report a 28-year-old man who presented with dyspepsia, nausea, vomiting, and black-colored stools. Endoscopy revealed a growth at the incisura, a biopsy specimen from which was reported as a poorly differentiated tumor. The patient underwent subtotal gastrectomy and the resected specimen showed a 6.5 x 4-cm circumferential growth in the antropyloric region. Histological sections from the growth showed transmural infiltration by deeply eosinophilic cells with hyperchromatic nuclei. A differential diagnosis of epithelioid GIST, rhabdoid variant, hepatoid variant, and signet-ring cell adenocarcinoma was considered. Special stains and immunohistochemistry confirmed the tumor to be a variant of signet-ring cell adenocarcinoma of the stomach. Morphologic variations of signet-ring cell carcinoma pose an important diagnostic dilemma, which has therapeutic and prognostic significance for the patient. These variants need to be recognized by pathologists to enable an accurate diagnosis.
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PMID:Deeply eosinophilic cell variant of signet-ring type of gastric carcinoma: a diagnostic dilemma. 1846 67

The fluoroquinolones ciprofloxacin, levofloxacin, moxifloxacin and gemifloxacin are widely used for the treatment of various types of bacterial infections. Overall, these antibacterial agents can be considered safe and well tolerated drugs. Comparative studies have evaluated the use of quinolones in elderly and younger populations. Although age per se does not seem to decrease their tolerability, specific adverse effects of the quinolones must be considered when they are chosen for antibacterial treatment. Renal function declines consistently with age and doses of renally excreted quinolones (e.g. ofloxacin, levofloxacin, gatifloxacin) need to be adjusted if a clinically relevant reduction of creatinine clearance is identified. Reactions of the gastrointestinal tract, such as nausea, dyspepsia, vomiting or diarrhoea, are among the most often registered adverse drug reactions during therapy with fluoroquinolones. Treatment with a quinolone causes diarrhoea less frequently than treatment with other classes of antimicrobials. Conflicting data have been published with respect to the incidence of Clostridium difficile-associated diarrhoea in quinolone-treated patients. Hypersensitivity reactions, often manifested on the skin, occur less commonly during therapy with quinolones than, for example, during therapy with beta-lactam antibacterials. Adverse reactions of the CNS are of particular concern in the elderly population. Given the CNS excitatory effects of quinolones, elderly patients should be monitored carefully for such symptoms. It is likely that many signs of possible adverse reactions, such as confusion, weakness, loss of appetite, tremor or depression, are often mistakenly attributed to old age and remain unreported. Quinolones should be used with caution in patients with known or suspected CNS disorders that predispose to seizures (e.g. severe cerebral arteriosclerosis or epilepsy). Quinolones can cause QT interval prolongation. They should be avoided in patients with known prolongation of the QT interval, patients with uncorrected hypokalaemia or hypomagnesaemia and patients receiving class IA (e.g. quinidine, procainamide) or class III (e.g. amiodarone, sotalol) antiarrhythmic agents. Tendinitis and tendon ruptures are recognized as quinolone-induced adverse effects that can occur during treatment or as late as several months after treatment. Chronic renal diseases, concomitant use of corticosteroids and age >60 years are known risk factors for quinolone-induced tendopathies. Overall, the specific adverse-effect profile of quinolones must be considered when they are chosen for treatment of bacterial infections. Because of physiological changes in renal function and when certain co-morbidities are present, some special considerations are necessary when elderly patients are treated with these drugs.
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PMID:Safety considerations of fluoroquinolones in the elderly: an update. 2021 Mar 67

The milk-alkali syndrome was a common cause of hypercalcemia, metabolic alkalosis, and renal failure in the early 20th century. It was caused by the ingestion of large quantities of milk and absorbable alkali to treat peptic ulcer disease. The syndrome virtually vanished after introduction of histamine-2 blockers and proton pump inhibitors. More recently, a similar condition called the calcium-alkali syndrome has emerged as a common cause of hypercalcemia and alkalosis. It is usually caused by the ingestion of large amounts of calcium carbonate salts to prevent or treat osteoporosis and dyspepsia. We describe a 78-year-old woman who presented with weakness, malaise, and confusion. She was found to have hypercalcemia, acute renal failure, and metabolic alkalosis. Upon further questioning, she reported use of large amounts of calcium carbonate tablets to treat recent heartburn symptoms. Calcium supplements were discontinued, and she was treated with intravenous normal saline. After 5 days, the calcium and bicarbonate levels normalized and renal function returned to baseline. In this article, we review the pathogenesis of the calcium-alkali syndrome as well as the differences between the traditional and modern syndromes.
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PMID:The calcium-alkali syndrome. 2354 83

Hyponatremia is a common phenomenon in psychiatry occurring as an adverse effect to drugs or following polydipsia. We performed a retrospective in-depth analysis of hyponatremia cases in a large unselected population of psychiatric inpatients. During a 3-year period, all cases of hyponatremia were identified among patients admitted to a large psychiatric state and university hospital by the institution's electronic laboratory database. Demographic, treatment-related, and laboratory data were obtained by consecutive chart review, respectively. Hyponatremia occurred in 347 (4.9%) of 7113 cases, of which the majority (78%) displayed only a mild manifestation. Symptoms were recorded in 28.8% of cases, already occurred in mild forms, and comprised gait impairment (45%, including falls), confusion (30%), sedation (26%), and dyspepsia (41%). Age, female sex, nonpsychiatric drug polypharmacy-particularly with thiazides and/or angiotensin-converting enzyme inhibitors-and diagnosis of a mood disorder were associated with more severe hyponatremia, respectively. The proportion of hyponatremic patients treated with venlafaxine, trazodone, carbamazepine, oxcarbazepine, and first-generation antipsychotics, respectively, was significantly higher in the hyponatremia sample than in the normonatremic population. This was, surprisingly, not the case with selective serotonin reuptake inhibitors or any other antidepressant drug class. We found prescription with second-generation antipsychotics to be significantly associated with less severe hyponatremia.Hyponatremia may be mainly attributed to the syndrome of inappropriate antidiuretic hormone secretion, as indicated by decreased serum osmolarity in our sample. Besides old age and female sex, treatment with certain drugs-rather than whole drug classes-carries a substantially increased risk.
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PMID:Epidemiology, symptoms, and treatment characteristics of hyponatremic psychiatric inpatients. 2405 56

Leptomeningeal carcinomatosis (LMC) from gastrointestinal cancer would be rare. A 56-years old man with complaint of dyspepsia and histopathologic examination of the biopsy specimens has shown: adenocarcinoma. At the end of adjuvant chemo radiation therapy, the patient has affected by headache and mild confusion. In cerebrospinal fluid (CSF) cytology, a plenty of malignant cells have seen and unfortunately after a short time for about 4 days after ICU admission, the patient has died. This could be due to heavy burden of disease in central nervous system.
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PMID:A report of a rare gastric cancer case: leptomeningeal carcinomatosis. 2582 73


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