Assuntos
Humanos , Síndrome de Imunodeficiência Adquirida/dietoterapia , Nutrição dos Grupos Vulneráveis , Desnutrição Proteico-Calórica , Avaliação Nutricional , Programas de Nutrição , Anorexia/dietoterapia , Dietoterapia/métodos , Doenças do Esôfago/dietoterapia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/complicações , Doenças do Sistema Nervoso CentralRESUMO
A patient with two uncommon manifestations of Behcet's Syndrome, oesophageal ulceration, and glomerular disease is presented. In both systems, as in all others affected by Behcet's Syndrome, there was vasculitis principally involving veins, venules, and capillaries. Response to conventional management was not successful. (AU)
Assuntos
Humanos , Relatos de Casos , Síndrome de Behçet/complicações , Doenças do Esôfago/etiologia , Glomerulonefrite/etiologia , Vasculite/terapiaRESUMO
The esophagus may be the origin of chest pain clinically indistinguishable from that of ischemic heart disease. In some patients the esophageal origin of the pain may only be recognized by pharmacological provocation during manometry. We describe nine patients with chest pain which could be explained by disorders of esophageal motility-diffuse spasm in four, high pressure lower esophageal sphincter in three, and "nutcracker esophagus" in two. Methacholine provoked the pain and manometric abnormalities in five patients who had normal baseline tracings. However, seven patients given methacholine developed ischemic changes on the electrocardiogram. In one patient these were typical of Prinzmetal's variant angina. The mannometric and electrocardiographic abnormalities were reversed by intravenous atropine. Ischemic heart disease and esophageal motor disorders may occur concomitantly and pose a dilemma in diagnosis and management. (AU)
Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Doença das Coronárias/diagnóstico , Doenças do Esôfago/diagnóstico , Junção Esofagogástrica/fisiopatologia , Dor/etiologia , Tórax , Doença das Coronárias/fisiopatologia , Doença das Coronárias/diagnóstico por imagem , Deglutição/efeitos dos fármacos , Diagnóstico Diferencial , Eletrocardiografia , Doenças do Esôfago/fisiopatologia , Manometria/métodos , Compostos de Metacolina/diagnóstico , Peristaltismo , Pressão , Espasmo/induzido quimicamente , Taquicardia/induzido quimicamente , Transdutores de PressãoRESUMO
A study of the radiological appearances and pathological features of a series of 17 cases of hypertrophic pyloric stenosis of the adult revealed several interesting features. It was shown that the generally accepted radiological description of smooth, severe and regular narrowing and elongation of the pyloric canal is only present in a proportion of cases. The radiological picture is very variable and many cases presented with an irregular pyloric canal and antrum with only moderate degree of narrowing or of pyloric stenosis. The classical pathological changes are said to be those of hypertrophy and hyperplasia of the circular muscle of the pyloric canal and adjacent part of the antrum. The use of special staining techniques revealed varying amounts of fibrous tissue in the hypertrophied smooth muscle in every case, a feature only briefly referred to in one or two previous communications. The presence of fibrous tissue is compatible with the theory that hypertrophic pyloric stenosis of the adult is secondary to pyloric channel ulcer and further evidence is presented in support of this. In a significant proportion of cases, the pyloric muscle hypertrophy is complicated by the presence of a benign ulcer on the lesser curvature of the stomach. The significance of this is also discussed
