Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the 14 yr from 1965 through 1978, 49 infants presented shortly after birth with intestinal obstruction due to impacted meconium. Three of these patients did not have fibrocystic disease. Eight patients were cured by a Gastrografin enema. There were 18 patients who had complications that included associated atresia, volvulus, and/or peritonitis. Various operations were done including resection with either primary anastomosis or enterostomy or varieties of the foregoing. Twenty-three babies had the simple uncomplicated form of meconium ileus. Eleven of these underwent resection and six patients died. Twelve patients were treated by laparotomy, ileotomy through a purse-string suture and prolonged irrigations using acetylcysteine. Of this group only one succumbed. This latter course of management is recommended for patients with simple uncomplicated meconium ileus as it involves no resection, no enterostomy, nor any primary anastomosis.
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PMID:Meconium ileus: laparotomy without resection, anastomosis, or enterostomy. 55 Nov 49

Gastrografin (methylglucamine diatrizoate) enemas were carried out in 2 newborn infants with meconium ileus. Evacuation was slow and incomplete. Both patients died within 72 hours following enemas from bowel necrosis, perforation and peritonitis. Although it is not possible to implicate Gastrografin directly as the cause, it is suggested that it may have contributed substantially to bowel necrosis. Recent experimental evidence of colonic inflammation and occasionally necrosis caused by Gastrografin lends support to this hypothesis. Caution should be exercised to prevent not only the systemic osmotic effects of Gastrografin, but also potential local injury to the bowel, especially when underlying disease interferes with intestinal viability.
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PMID:Possible adverse effect of methylglucamine diatrizoate compounds on the bowel of newborn infants with meconium ileus. 98 69

Ulcerative colitis may occur on several forms. Toxic megacolon is roentgenologically characterized by dilatation usually in the area of transverse colon and toxic symptoms. At the first appearance of these symptoms the patient should be treated or operated upon. Under normal circumstances the roentgenological diagnosis may be obtained only by a full erect or a left lateral decubitus film of the abdomen. A barium enema could lead to performation of the colon, peritonitis or provocation of toxic megacolon. In doubtful cases the examination should be performed with water-solubel contrast media (i. e. Gastrografin, Propyliodon etc.) The therapeutical internal and surgical possibilities are discussed.
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PMID:[Clinical and roentgenological aspects of toxic megacolon (author's transl)]. 100 9

A captive-bred male baboon presented with severe evidence of blood loss and melaena. An upper gastrointestinal radiological study with Gastrografin showed a large trichobezoar. Laparotomy confirmed its presence and revealed gastric ulceration with perforation and generalized peritonitis. The condition was successfully treated by surgery.
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PMID:Gastric haemorrhage and perforation caused by a trichobezoar in a baboon (Papio hamadryas). 236 17

This report describes 51 neonates with meconium ileus and emphasizes a changing pattern of treatment and improved survival. Twenty-four neonates had uncomplicated meconium ileus due to inspissated meconium obstructing the distal ileum. Twenty-seven neonates had 41 complications of meconium ileus including volvulus (18), bowel atresia (13), perforation (5), and giant cystic meconium peritonitis (5). Nine patients with uncomplicated cases responded to nonoperative clearing of meconium using a meglumine diatrizoate (Gastrografin) enema. Six of 7 patients with enema failures underwent laparotomy, purse-string enterotomy, and intraluminal irrigation. The remaining 9 patients with uncomplicated meconium ileus had resection and enterostomy. Complicated cases were managed by resection and anastomosis (13) or enterostomy (14). Survival at 1 year was 92% in patients with uncomplicated meconium ileus and 85% for those with complicated meconium ileus. Nonoperative Gastrografin enema or enterotomy-irrigation can relieve obstruction in uncomplicated meconium ileus and avoid an enterostomy in most cases.
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PMID:Changing patterns of treatment and survival in neonates with meconium ileus. 274 86

This study evaluates the use of iohexol as a radiographic diagnostic contrast agent in normal animals and those with experimental bowel ischemia and obstruction. Eighteen rats and 12 rabbits were gavaged with iohexol in a dose of 7.5 mL/kg using concentrations of 140 mg I/mL (isotonic with blood) or 300 mg I/mL. In addition, four rabbits had intraperitoneal iohexol injection and three were given gastrografin gavage. Experimental groups included normal bowel controls, bowel injury induced by ischemia and alcohol contact, bowel obstruction by ligature, and intraperitoneal injection. Serial abdominal radiographs and plasma concentrations of iohexol were obtained. Iohexol remained stable throughout the gastrointestinal tract, retained its intensity, and was well visualized up to four days after administration. Bowel images were fair at concentrations of 140 mg I/mL and excellent at 300 mg I/mL. Gastrografin caused bowel distention and poor visualization related to dilution. It also precipitated in the stomach. Iohexol was rapidly absorbed from the peritoneal cavity and excreted by the kidneys, without causing peritonitis. Rat plasma iohexol levels were three times controls in obstructed bowel and 80 times controls if there was mucosal injury without perforation. Rabbit peak plasma levels were 30 times greater following intraperitoneal injection than with gastric gavage. These observations suggest that iohexol may be useful as a gastrointestinal contrast agent. Measuring plasma iohexol levels may be helpful in the evaluation of suspected bowel ischemia or perforation in the clinical setting.
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PMID:Use of iohexol in the radiographic diagnosis of ischemic bowel. 372 5

The majority of patients admitted to the hospital with left lower quadrant peritonitis and suspected acute diverticulitis are treated empirically without colon radiography either for the duration of their hospital course, or until such time as it is deemed safe to perform a barium enema to confirm this diagnosis. Unlike barium, a water-soluble contrast agent such as Gastrografin can be used safely and accurately immediately on hospitalization. Early establishment of an accurate diagnosis can help eliminate complications, morbidity, mortality, and lengthy hospitalizations. Seventy-one patients admitted with left lower quadrant peritonitis, temperatures above 99.5 degrees F, and leukocytosis were evaluated. Treatment either was based on a diagnosis established by results of a barium enema or water-soluble contrast enema, or was empiric in nature. The early use of a water-soluble contrast enema in the elucidation of the cause of left lower quadrant peritonitis proved to be the most accurate and also the most cost-effective means of diagnosis.
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PMID:The initial management of left lower quadrant peritonitis. 375 2

During the 15 years from 1970 to 1984, 38 infants, all with cystic fibrosis, were treated for meconium ileus at The Montreal Children's Hospital and Ste-Justine Hospital for Children. Thirteen patients (34%) had complicated meconium ileus that included 7 perforations (2 colon, 5 ileum), 4 volvulus, and 2 atresia with meconium pseudocyst. In this group, various operations were done: resection with primary anastomosis for atresia, or resection with enterostomy for peritonitis or volvulus. One died shortly after surgery. Of 25 patients with uncomplicated meconium ileus (66%), one died shortly after arrival from respiratory distress, leaving 24 patients available for study. Gastrografin enema was attempted on 20 patients with eight successes (40%). Of the remaining 16 patients with unresolved meconium ileus, nine were treated with laparotomy and ileostomy, and one with laparotomy and T-tube irrigation. Six patients were treated by laparotomy and enterotomy for irrigation with N-acetylcysteine and evacuation by Fogarty catheter, a technique not widely used. No one succumbed in this group. This latter method of management is recommended for patients with simple uncomplicated meconium ileus.
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PMID:Meconium ileus: is a stoma necessary? 377

Meconium ileus was noted as an early manifestation of cystic fibrosis in 60 neonates between 1972 and 1991. There were 20 girls and 40 boys. A family history of cystic fibrosis was present in six children. Twenty-five neonates had uncomplicated meconium ileus due to inspissated meconium within the terminal ileum. Thirty-five neonates presented with 56 complications of meconium ileus, including volvulus (n = 22), atresia (n = 20), perforation (n = 6), and giant cystic meconium peritonitis (n = 8). Clinical presentation included abdominal distension, bilious vomiting, and failure to pass meconium. In two recent cases, prenatal ultrasonography detected a mass with proximal bowel distension indicative of cystic meconium peritonitis. Mechanical bowel obstruction in the other neonates was diagnosed from plain abdominal radiographs and barium enema. Ten patients with uncomplicated meconium ileus were successfully treated with a diatrizoate meglumine (Gastrografin) enema. The remaining 15 patients required a laparotomy, with 9 treated by bowel resection and enterostomy and 6 recent cases managed with enterotomy and irrigation. Complicated cases were managed by bowel resection and anastomosis (n = 15) or enterostomy (n = 20). Survival at 1 year was 92% in patients with uncomplicated meconium ileus and 89% for those with complicated meconium ileus. The therapy of choice for uncomplicated meconium ileus is nonoperative Gastrografin enema, with enterotomy and irrigation reserved for enema failures. Complicated cases require exploration and, in the absence of giant cystic meconium peritonitis, are usually amenable to bowel resection and primary anastomosis.
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PMID:Contemporary management of meconium ileus. 833 77

We sought to investigate the effects of high glucose concentration, osmolality, and heat sterilization of peritoneal dialysis fluids on tumor necrosis factor-alpha (TNF-alpha) production by peripheral blood mononuclear cells (PBMC) and polymorphonuclear cell (PMN) functions. Blood samples were obtained from eight healthy volunteers. PBMCs and PMNs were harvested by centrifugation with Ficoll-Hypaque (Sigma, St Louis, MO). PBMC were incubated with an equal volume of test fluids and RPMI for 4 hours (pH equilibrated), followed by incubation for 20 hours in RPMI with or without endotoxin (10 ng/mL). Total TNF-alpha production was measured by radioimmunoassay. PMNs were incubated with pH-adjusted test fluids for 30 minutes. After incubation, phagocytosis was determined by the uptake of 14C-labeled Staphylococcus aureus, oxidative burst by reduction of ferricytochrome C to ferrouscytochrome C on stimulation with phorbol myristate acetate, and enzyme release by measurement of endotoxin-stimulated bactericidal/permeability increasing factor. To study the effects of increasing glucose concentration and osmolality on PBMC and PMN functions, we compared conventional 1.5% Dianeal (1.5%D), (Baxter Healthcare Corp, Deerfield, IL) 2.5% Dianeal (2.5%D), 4.25% Dianeal (4.25%D), and control (RPMI for PBMCs and Hank's balanced salt solution for PMNs). PMNs exposed to 4.25%D exhibited an inhibition of phagocytosis, phorbol myristate acetate (PMA)-stimulated oxidative burst, and bactericidal/permeability increasing factor release compared with control, 1.5%D, or 2.5%D. To study the effects of increased osmolality when controlled for glucose concentration, we compared 1.5%D with 1.5%D in which osmolality was increased to that of 4.25%D with the addition of either sodium chloride (1.5%D+NaCl) or mannitol (1.5%D+M). High osmolality induced higher TNF-alpha production by unstimulated PBMCs and decreased TNF-alpha production by endotoxin-stimulated PBMCs. PMN functions were also inhibited by high osmolality. To study the effects of increased glucose concentration when controlled for osmolality, we compared 4.25%D with 1.5%D+NaCl and 1.5%D+M. High glucose concentration induced an increase in TNF-alpha production by unstimulated PBMCs, a decrease in TNF-alpha production by endotoxin-stimulated PBMCs, and an inhibition of PMN functions. Finally, to investigate the effects of heat sterilization, we compared 4.25%D (heat sterilized) to a filter-sterilized 4.25%D (4.25%D-F). The filter-sterilized fluid induced less changes in PBMC and PMN functions compared with the heat-sterilized fluid. These data suggest that the high glucose concentration, high osmolality, and heat sterilization of peritoneal dialysis fluids adversely affect PBMC and PMN functions. These effects could predispose continuous ambulatory peritoneal dialysis patients to peritonitis, compromise host defense during infection, and jeopardize long-term survival of the peritoneal membrane.
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PMID:Effect of glucose concentration, osmolality, and sterilization process of peritoneal dialysis fluids on cytokine production by peripheral blood mononuclear cells and polymorphonuclear cell functions in vitro. 946 98


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