Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary lymphomas of the small intestine (PIL) show definite racial and geographic distribution. Clinical and laboratory data on 132 patients with PIL treated and followed up over a 14-year period in Baghdad, Iraq, are presented. Based on the pattern of involvement of the bowel and the histopathologic appearance of the tumor, the patients can be divided into three main groups. Ninety-seven patients had diffuse lymphoplasmacytic infiltration affecting large segments of the upper bowel. Abdominal pain, anorexia, weight loss, diarrhea, malabsorption, and clubbing of the fingers are the most common clinical findings. The barium appearance of the small intestine and peroral jejunal biopsy specimens are abnormal in nearly all cases. This clinicopathologic entity has been referred to in the literature as Mediterranean lymphoma (ML). Ten of 34 patients tested had free alpha-heavy chain in the serum. Twenty-three cases had other "Western" variants of lymphoma (18 lymphocytic and 5 plasmacytic). The lesions were localized, occurring most frequently in the lower ileum or ileocecal area. The most common presentation was intestinal obstruction. Twelve children had Burkitt's lymphoma (BL), presenting most commonly with abdominal masses and/or intestinal obstruction. These patients responded poorly to cyclophosphamide, and the disease disseminated early and extensively. None of the patients with the localized lymphomas or BL had free alpha chain in the serum.
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PMID:Clinical and pathologic subtypes of primary intestinal lymphoma. Experience with 132 patients over a 14-year period. 641 50

Sixty-four cases of gastrointestinal linear foreign body in the cat were reviewed. Most of the cats were less than 4 years old. The most common clinical signs were persistent vomiting, partial to complete anorexia, and depression. Abdominal palpation by itself was rarely diagnostic. Diagnosis in approximately 75% of the cases was possible, however, by using a combination of oral examination and abdominal palpation. Survey radiography contributed to the diagnosis in 86% of the cases in which it was used, based on evidence of bowel plication, presence of tapered, enteric gas bubbles, gathering of the small intestine, peritonitis, intestinal needles, or bowel obstruction. Surgery (gastrotomy and multiple enterotomies) was necessary in 96.9% of the cases, and most of the cats so treated did well (83.9%). Approximately 50% of the cats with linear foreign body-induced bowel lacerations recovered.
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PMID:Thread and sewing needles as gastrointestinal foreign bodies in the cat: a review of 64 cases. 669 39

Intramural hematoma of the intestine caused intestinal obstruction in three dogs. Two dogs were examined because of vomiting and anorexia of several weeks' duration. In one of these, an intramural hematoma of the duodenum was associated with chronic pancreatitis. A cause was not found in the second dog. The third dog, which had clinical and radiographic evidence of gastric dilatation, was found at surgery to have hemoperitoneum associated with a ruptured intramural intestinal hematoma. In 1 dog, the hematoma was evacuated through a serosal incision. In the other 2 dogs, the problem was resolved by resection of the involved segment of intestine, followed by anastomosis. All 3 dogs recovered without complications.
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PMID:Intramural intestinal hematoma causing obstruction in three dogs. 669 51

A phase I study of a new fluorinated pyrimidine, 1-hexylcarbamoyl-5-fluorouracil (HCFU), was performed by a multi-institutional clinical study group using a total of 111 patients with histologically proven malignancies. The characteristic toxic effects were a transient hot sensation and pollakiuria, which occurred 15-120 minutes after oral administration of the drug, continued for 30 minutes to 4 hours, and subsided spontaneously. Gastrointestinal disturbances such as nausea, vomiting, diarrhea, and anorexia, which are common with 5-FU administration, also occurred with HCFU but did so less frequently. The maximum tolerated dose for a single oral administration was estimated to be between 12 and 15 mg/kg and the optimal daily dose for continuous administration was considered to be between 9 and 18 mg/kg, with divided daily administration. Fifty-seven patients received 5-19 mg/kg/day of HCFU for > 4 weeks, including 31 patients with > 60 days' treatment. Cumulative doses were from 9.5 to 166.2 g, with a mean of 26.3 g. Hematopoietic toxicity was slight and hepatic toxicity was questionable. No renal or other cumulative toxicity was observed. In ten of the 57 patients, favorable clinical effects were seen: an active decrease in the size of the solid tumor (three patients), the disappearance of ascites (six), and the improvement of intestinal obstruction due to peritoneal carcinomatosis (one).
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PMID:Phase I study of a new antitumor drug, 1-hexylcarbamoyl-5-fluorouracil (HCFU), administered orally: an HCFU clinical study group report. 744 23

Though many of the treatment strategies used in palliative care have never been subjected to clinical trial, it has been argued that advances in palliative care have outstripped those in many other specialties. This article is not a comprehensive review of therapeutic options, nor even of recent advances in this topic, but concentrates on the latest developments and controversies in the pharmacological treatment of four frequent and important symptoms: neuropathic pain, anorexia and cachexia, intestinal obstruction, and breathlessness. It is difficult to perform blinded, randomised trials in patients with advanced disease and poor performance status, yet it is these patients who may gain most from the adoption of new well evaluated treatment strategies.
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PMID:Palliative care. 751 47

Earlier studies have reported that faecal pH is more alkaline in patients with colonic cancer, indicating a reduction in colonic carbohydrate fermentation to organic acids. The pH of faeces from 11 pre and 14 postoperative, selected colonic cancer patients without intestinal obstruction, major loss of appetite or weight, not treated with antibiotics, and without signs of dissemination or recurrence of the cancer, did not differ, however, from faecal pH in 17 patients with previous colonic adenomas removed by polypectomy and faecal pH in 17 age matched (mean 61 years) healthy controls (mean (SE) 7.03 (0.10), 7.15 (0.11), 7.20 (0.12), 7.11 (0.12) respectively; p = 0.82). Faecal pH in 20 younger (mean 32 years) healthy controls tended to be lower (6.89 (0.07) compared with the older age matched control group (p < 0.06). Faecal concentrations of D-, L- or total D+L-lactate did not differ between the patients with present or previous colonic cancer, adenomas, and the healthy controls (D+L-lactate mean (SE) 3.2 (0.5), 3.1 (0.3), 3.5 (0.7), 4.1 (1.0) mmol/l respectively; p = 0.72), and the production pattern of lactate from different carbohydrates (glucose and dietary fibre) in 16.6% faecal homogenates was similar in all the three groups of patients and the healthy controls. Faecal pH was changed within days by modifications of the diet. An enteral diet free of fibre, starch, and lactose increased faecal pH within three days, whereas pH decreased when the colonic load of carbohydrates was increased by lactulose. Therefore, the reported alkaline faecal pH in patients with colonic cancer may reflect short term reduction in dietary intake and colonic fermentation secondary to the presence of the cancer, especially in patients with advanced disease, rather than long term differences in the precancer dietary habits.
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PMID:Lactate and pH in faeces from patients with colonic adenomas or cancer. 838 10

A 3-month-old llama with a presenting complaint of lethargy, anorexia, and a painful, distended abdomen was evaluated. The llama had intermittently strained to defecate during the 3 days prior to admission. Physical examination results, hematologic data and lateral abdominal radiographs were used to diagnose a large umbilical abscess, which was causing a partial obstruction of the gastrointestinal tract. Under general anesthesia, 3 liters of purulent exudate were drained from the abscess. The abscess cavity was then lavaged with saline solution and its capsule was marsupialized to the skin. Cultures of the abscess content yielded Proteus sp, Streptococcus equisimilis, and Clostridium septicum. Two days after surgery, the llama was drinking, eating, and passing feces. The abscess was lavaged daily for a total of 11 days. Six months after surgery, the llama was the same size as other llamas of the same age, and the owners were pleased with the cosmetic appearance of the ventral abdomen. Umbilical abscesses can vary in size and clinical presentation; they should be recognized as a possible cause of abdominal pain with a potential for causing intestinal obstruction in llamas.
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PMID:Abdominal pain associated with an umbilical abscess in a llama. 841 58

Many factors can modify nutritional status in cancer patients, including cachexia, nausea and vomiting, decreased caloric intake or oncologic treatments capable of determining malabsorption. Cachexia is a complex disease characterized not only by a poor intake of nutrients or starvation, but also by metabolic derangement. Nausea and vomiting may limit the nutrient intake and are most often the consequences of oncologic treatments or opioid chronic therapy. Decreased caloric intake is considered to be one of the major causes of malnutrition, although the causes of anorexia remain unclear. Malabsorption is generally attributed to the consequences of oncologic treatments reducing the gastrointestinal absorption. Biochemical measurements and immunological tests may be not reliable indicators of nutritional status in cancer patients. Therefore, medical history, physical examination, estimates of daily oral intake, weight changes and an appropriate consideration of the nutritional requirements according to the stage of disease must still be assessed. The therapeutic approaches should be individualized and realistic. Whenever possible, oral nutrition is the method of choice, with due consideration for specific dietary needs. Nausea and anorexia can be reduced by different kinds of drugs. A careful decision based on good clinical judgement is necessary before deciding to start either enteral or parenteral nutrition, to avoid a useless, costly and difficult treatment. In choosing the route for administration of nutrients, availability of and access to a functioning gastrointestinal tract, compliance and comfort of the patient, gastrointestinal toxicity due to chemotherapy or radiotherapy fields, different costs, duration and place of treatment should be considered rather than the different capacity of parenteral versus enteral nutrition. However, postoperative periods after massive intestinal resection often require prolonged parenteral nutrition. The benefits of parenteral nutrition are not often demonstrable in patients with bowel obstruction. Different ethical aspects are presented. Flexibility in attempting to meet the nutrition needs of each patient is probably the most useful guide.
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PMID:Nutrition in cancer patients. 877 Dec 86

For the patient with advanced pancreatic cancer, curative strategies may not be appropriate, and palliative symptom management may be the best approach to patient care. Oncologists, who have been trained to concentrate on curing cancer, must shift focus when caring for these patients and consider palliative treatment strategies. Pancreatic cancer patients are multisymptomatic and may require treatment for such conditions as pain, bowel obstruction, anorexia, early satiety, cachexia, nausea and vomiting, constipation, diarrhea, ascites, and dyspnea, among others. These patients may be most effectively managed in a hospice care center, which can provide comprehensive care. Alternatively, new programs, such as the Cleveland Clinic Palliative Care Program, provide a unique setting for the patient with advanced cancer that integrates the qualities of hospice care into the acute medical care system.
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PMID:Palliative management of the patient with advanced pancreatic cancer. 888 9

For studying abdominal tuberculosis (TB) in Ahmadi, files off all patients admitted to our hospital with abdominal TB over 15 years (1981-1996) were reviewed. Nineteen patients are reported here. Young adults were predominant in our study. The non-Arab Asians were the most frequently affected group in relation to their population in Ahmadi, and Kuwaitis were the least frequently affected group. Abdominal pain, sweating, anorexia and fever were the most frequent presenting symptoms. Ascites and intestinal obstruction were the most frequent clinical presentations. Two patients presented with acute appendicitis and one patient had tuberculous pancreatitis. Abdominal lymph nodes, peritoneum, ileum and and caecum were the most frequently affected abdominal structures. We found laparoscopy very helpful in diagnosis of abdominal TB and we recommend it as the diagnostic method of choice. All our patients responded well to antituberculous chemotherapy. It should be kept in mind that abdominal TB still affects the indigenous and expatriate population of Kuwait.
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PMID:Abdominal tuberculosis in Ahmadi, Kuwait: a clinico-pathological review. 970 Feb 74


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