Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using a double-lumen tube perfusion system, solutions of glucose (1.0, 2.5, and 5.0 g 100ml(-1)) have been perfused into the upper jejunum of 22 Zambian African subjects in order to study their glucose absorption kinetics. None of them had clinical evidence of malnutrition or intestinal disease. In 10 there was no evidence of an infective disease (;normal' group); seven had tuberculosis; five had acute bacterial infections. The mean serum albumin concentration was significantly lower in those with infections; the mean total and gamma-globulin concentrations were significantly higher in the tuberculosis group. There was good reproducibility in triplicate assessments of glucose and water absorption rates in the individual subjects. Despite a wide scatter, the mean glucose kinetic curves were significantly flatter in those with infections than in the normal group (p<0.02). There was a significant association between glucose and water absorption rates in the individuals. D-xylose absorption was estimated in 11 subjects and there was a significant correlation between that and the glucose absorption rate. Jejunal morphology (n=9) and disaccharidase concentrations (n=6) were normal for African subjects and there were no significant associations between either of those and the absorption rates. Galactose absorption kinetics have been studied in an additional four relatively normal Zambian Africans. This study suggests that systemic bacterial infections can produce malabsorption. This may be relevant to the weight loss in patients with pulmonary tuberculosis and also to the aetiology of kwashiorkor.
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PMID:Glucose absorption kinetics in Zambian African patients with and without systemic bacterial infections. 411 99

A case of malabsorption and subtotal villous atrophy secondary to pulmonary and intestinal tuberculosis is reported. The patient was a 21-year-old Chinese girl who had active pulmonary tuberculosis, malabsorption, subtotal villous atrophy, atrophic gastritis with hypochlorhydria, ileal stricture, and a severe non-specific anaemia. There was also evidence to suggest protein-losing enteropathy. The association of subtotal villous atrophy and atrophic gastritis with tuberculosis is discussed. When antituberuclous therapy was instituted, improvement was marked not only clinically but also in the tests for intestinal absorption and in the jejunal mucosa.
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PMID:Malabsorption and subtotal villous atrophy secondary to pulmonary and intestinal tuberculosis. 542 99

A patient is described with a severe malabsorption syndrome which failed to respond to a gluten-free diet. Although subtotal villous atrophy was present in the jejunal mucosa, histological features of subepithelial fibrosis and apparently normal enterocytes were not suggestive of coeliac disease. The findings of decreased mucosal thickness, of a normal mitotic rate in the crypt cell population, and of the decreased rate of loss of epithelial cells further suggested that the disease process producing the ;flat' mucosa was not that of coeliac disease. The condition was complicated by ileal ulceration and active tuberculosis.
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PMID:A case of small-intestinal mucosal atrophy. 547 5

We describe an unusual case of Whipple's disease, in a patient previously treated for tuberculosis, in which involvement of the small intestine was restricted to the submucosa. This is of diagnostic importance since the presence of Whipple's disease cannot be established by jejunal biopsy in such cases unless the submucosa is adequately sampled. It is possible that this unusual distribution of intestinal infection is related to the effects of e antibiotic therapy. Retrospective study of the patient's serum cholesterol, carotene, and albumin suggests that malabsorption may occur in Whipple's disease despite the absence of infection in the mucosa.
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PMID:A submucosal variant of Whipple's disease. 617 78

Tuberculosis of organs other than the lung may occur after an intestinal bypass operation for morbid obesity, with an incidence varying from 1% to 4%, a value rather higher than that of the general population. As its clinical symptoms (fever and chills, abundant sweating and an increase or return of weight loss) appear during the period of greatest weight loss, it is probably caused by malnutrition and malabsorption. In most cases lymphadenopathy (usually cervical) also appears. Tuberculosis occurring after bypass operation should be treated with the classic antitubercular therapy; this always results in recovery if the disease is diagnosed in time.
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PMID:Tuberculosis after intestinal bypass for morbid obesity. 721 57

A study was carried out in the patients with intestinal tuberculosis and obstruction requiring surgery to determine the pathogenesis of malabsorption in this condition. Fifteen of the 20 patients studied had malabsorption, nine of 17 (53%) had intestinal bacterial overgrowth and 10 of 16 (62.6%) had free bile acids in their jejunal aspirates. In a comparable group of nontuberculus intestinal obstruction requiring surgery, six of seven (85.7%) had malabsorption, and four of five (80%) had both the bacterial overgrowth as well as bile salt deconjugation. Among a group of 10 patients with intestinal tuberculosis without significant obstruction, four were found to have malabsorption but only one had evidence of bacterial overgrowth and bile salt deconjugation. In contrast, only one of the 10 patients with extraintestinal tuberculosis and none of the 12 healthy, normal subjects had malabsorption. None had bacterial overgrowth or bile salt deconjugation in either group. Resection of the obstructing lesion corrected the malabsorption as well as the bacterial overgrowth and the bile salt deconjugation in all four patients tested with intestinal tuberculosis. Malabsorption in intestinal tuberculosis thus appears to be associated with obstruction rather than with the tuberculous process. Demonstration of bacterial overgrowth and bile salt deconjugation in the upper small intestine of patients with intestinal tuberculosis with obstruction and malabsorption indicate the presence of a stagnant loop syndrome.
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PMID:A study of malabsorption in intestinal tuberculosis: stagnant loop syndrome. 735 98

Even though the oral contraceptive (OC) pill is the most effective reversible contraceptive, many OC users still conceive. Common reasons for OC failure are missed pills, drug interactions, and malabsorption caused by vomiting or diarrhea. The first report of OC failure linked to simultaneous use of another drug was in 1971. The drug was rifampicin, which was used to treat tuberculosis. Broad-spectrum antibiotics may inhibit OC efficiency through several mechanisms. Antibiotics destroy the bacteria which hydrolyse sulphate and glucuronide conjugates (metabolites of ethinyl estradiol). Thus, the enterohepatic recirculation of ethinyl estradiol that normally occurs is prevented, resulting in a reduction in plasma concentration of ethinyl estradiol. Antibiotic-induced diarrhea may increase urinary or fecal excretion of the OC. The antibiotic (e.g., rifampicin) may increase liver degradation of the OC hormones. There may even be other possible mechanisms. Experimental evidence for many of the commonly accepted mechanisms is lacking. Drug interactions are more common in users of the low dose estrogen OCs. In a review of drug interactions during 1968-1984, penicillins and tetracyclines were associated with 70% of cases. OCs with 30 mcg ethinyl estradiol comprised the greatest number of reports. Less than 10% of adverse drug reactions are reported to the Committee on Safety of Medicines via the yellow card plan. Dentists should advise female patients using OCs about reduced efficiency of the OCs while taking an antibiotic. They should follow the recommendations of the UK Family Planning Association. Dentists could routinely provide all female patients prescribed an antibiotic an information pamphlet that provides detailed advice and recommendations on the use of alternative methods. They have a professional obligation to know the physiology of reproduction, the pharmacology of drug interactions with the OC, and contraceptive methods.
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PMID:Oral contraceptives and antibiotics: important considerations for dental practice. 780 51

Infection due to Mycobacterium tuberculosis continues to plague humanity. In the United States, conditions have taken a decided turn for the worse, with an increasing frequency of infection and the spread of multiple-drug-resistant strains. A number of strategies are available to improve the management of this epidemic. Mycobacterium avium is now recognized as a significant cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. Therapy is limited due to relative drug resistance, drug intolerance, and drug malabsorption; however, potentially useful regimens are being developed.
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PMID:Mycobacterial infections. 830 90

Mycobacterium avium complex (MAC) is an infrequent pulmonary pathogen in immunocompetent hosts. In patients with AIDS, MAC causes disseminated infection (DMAC) in up to 50% of those with CD4+ counts less than 100 cells/mm3. A significant portion of the total body burden of MAC is found inside macrophages, and the distribution of organisms has implications for drug therapy. Clarithromycin, azithromycin, and rifabutin all appear to enter these cells well; rifampicin (rifampin), ethambutol, ciprofloxacin, and other agents also appear to enter these cells. MAC susceptibility is probably best tested using the radiometric method (BACTEC). Susceptibility break-points have been proposed for the various anti-MAC agents; however, solid clinical correlations have been achieved only for clarithromycin. Further research is required to establish break-points for the other agents. Based on current data, azithromycin and clarithromycin appear to be key drugs in the treatment of MAC, while rifabutin has been used more often than rifampicin in studies involving patients with AIDS. Among the drugs traditionally used for M. tuberculosis (TB), ethambutol, rifampicin and streptomycin are perhaps the most useful for MAC. Amikacin and clofazimine may also be useful. The limited data available on AIDS patients with MAC, plus additional data from AIDS patients with TB, suggest that malabsorption of the oral antimycobacterial drugs is common. Some drugs (rifampicin and ethambutol) appear to be particularly affected. Because most of the studies of DMAC have not evaluated the pharmacokinetics of the drugs, questions of drug efficacy cannot be separated from questions of biovailability. This significant oversight in study design should be eliminated from future investigations. Patient-specific susceptibility data combined with therapeutic drug monitoring and dosage individualisation is one way to identify problems with drug therapy and to overcome them. Because many of the drugs used in patients with AIDS affect the metabolism of concurrently used drugs, therapeutic drug monitoring is a valuable asset for untangling multiple drug interactions. Since drug therapy is the only aspect of a mycobacterial infection within our control, the better we control the drug therapy, the better our patients should do.
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PMID:Mycobacterium avium complex infection. Pharmacokinetic and pharmacodynamic considerations that may improve clinical outcomes. 906 28

We describe five compliant patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) that relapsed, with acquisition of resistance by the original Mycobacterium tuberculosis strains. Both the first and second isolates from each patient had the same IS (insertion sequence) 6110-based DNA fingerprint patterns. Three of the five patients developed TB that was resistant to rifampin alone; no mutation in the region of the rpoB gene was detected by a line probe assay in two of the isolates from these patients. We discuss several factors presumably associated with acquired drug resistance in HIV-infected patients, including exogenous reinfection, drug interactions, malabsorption of drugs, and the presence of a large organism burden.
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PMID:Acquired drug resistance in Mycobacterium tuberculosis isolates recovered from compliant patients with human immunodeficiency virus-associated tuberculosis. 940 54


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