Assuntos
Doenças Cardiovasculares/diagnóstico , Ablação por Cateter/normas , Competência Clínica/normas , Cardioversão Elétrica/normas , Técnicas Eletrofisiológicas Cardíacas/normas , American Heart Association , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/cirurgia , Educação Profissionalizante/normas , Técnicas Eletrofisiológicas Cardíacas/tendências , Humanos , Competência Profissional/normas , Ensino/normas , Estados UnidosAssuntos
American Heart Association , Cardiologia/normas , Competência Clínica/normas , Diagnóstico por Imagem/normas , Teste de Esforço/normas , Medicina Interna/normas , Garantia da Qualidade dos Cuidados de Saúde , Cardiologia/educação , Cardiologia/métodos , Criança , Ecocardiografia/normas , Humanos , Medicina Interna/educação , Medicina Interna/métodos , Pediatria/educação , Pediatria/métodos , Pediatria/normas , Angiografia Cintilográfica/normas , Estados UnidosRESUMO
An elderly black man was admitted to our institution with macrocytic anemia, dysphagia, and significant weight loss. Results of an esophagogram were suggestive of achalasia. Gastric adenocarcinoma infiltrating the gastric cardia was seen on gastroscopy. The mode of presentation of gastric cancer in this case has not been previously reported in association with pernicious anemia. Patients with pernicious anemia are at higher risk of having gastrointestinal neoplasms than is the general population. We review the current literature and address the controversy concerning the need to subject patients with pernicious anemia to surveillance with upper gastrointestinal endoscopy.
Assuntos
Adenocarcinoma/diagnóstico , Anemia Perniciosa/diagnóstico , Acalasia Esofágica/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Idoso , Anemia Macrocítica/diagnóstico , Anemia Perniciosa/complicações , Cárdia/patologia , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Acalasia Esofágica/diagnóstico por imagem , Gastroscopia , Humanos , Masculino , Radiografia , Fatores de Risco , Neoplasias Gástricas/complicações , Neoplasias Gástricas/diagnóstico por imagem , Redução de PesoRESUMO
Bleeding from esophageal varices is the most catastrophic complication of portal hypertension. The associated high morbidity and mortality have necessitated the development of safe and efficacious therapeutic modalities. In recent years, endoscopic band ligation of esophageal varices has proved to be a useful tool in the control of acute variceal bleeding and the prevention of recurrent bleeding. This endoscopic technique is faster than sclerotherapy in obliterating esophageal varices, and is associated with significantly lower local esophageal complications. In the forthcoming years, endoscopic band ligation is expected to gain wider popularity as a definitive therapy for bleeding varices.
Assuntos
Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Hemostase Endoscópica/métodos , Hemostase Endoscópica/instrumentação , Humanos , Ligadura/instrumentação , Ligadura/métodosAssuntos
Endoscopia Gastrointestinal/normas , Endoscopia Gastrointestinal/estatística & dados numéricos , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta/normas , Encaminhamento e Consulta/estatística & dados numéricos , Medição de Risco , Sociedades MédicasRESUMO
Serum gastrin levels were measured by radioimmunoassay in 62 patients with colorectal neoplasms (40 with adenomatous polyps and 22 with cancer) and 40 controls. Fasting serum gastrin in both the polyp (73.93 +/- 6.5 pg/ml) and the cancer (99 +/- 19.7 pg/ml) groups was significantly higher than those of the control group (42.65 +/- 2.2 pg/ml). These findings suggest that hypergastrinemia may be an etiologic factor in colorectal neoplasia.
Assuntos
Polipose Adenomatosa do Colo/sangue , Pólipos Adenomatosos/sangue , Neoplasias Colorretais/sangue , Gastrinas/sangue , Idoso , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Radioimunoensaio , Valores de ReferênciaRESUMO
In this study, we describe the successful induction of experimental autoimmune hepatitis by immunizing inbred strains of mice with syngeneic liver antigens. Hepatic lesions, presumably based on autoimmune mechanisms, induced after 3 weekly immunizations were of only moderate degree. Of the various mouse strains used, C57BL/6 mice showed the most prominent histological changes of the liver, which were accompanied by elevated serum alanine aminotransferase levels. This system offers a potential model for further investigating experimental autoimmune hepatitis.
Assuntos
Doenças Autoimunes/imunologia , Hepatite Animal/imunologia , Imunização , Fígado/metabolismo , Proteínas/imunologia , Alanina Transaminase/sangue , Animais , Doenças Autoimunes/sangue , Doenças Autoimunes/patologia , Feminino , Hepatite Animal/sangue , Hepatite Animal/patologia , Fígado/patologia , Masculino , Camundongos , Camundongos Endogâmicos , Proteínas/metabolismoAssuntos
Hepatite Alcoólica/terapia , Alcoolismo/complicações , Anabolizantes/uso terapêutico , Colchicina/uso terapêutico , Nutrição Enteral , Etanol/efeitos adversos , Feminino , Alimentos Formulados , Glucagon/uso terapêutico , Humanos , Insulina/uso terapêutico , Fígado/efeitos dos fármacos , Masculino , Metilprednisolona/uso terapêutico , Distúrbios Nutricionais/etiologia , Prednisona/uso terapêutico , Propiltiouracila/uso terapêuticoAssuntos
Adenocarcinoma/secundário , Neoplasias da Mama/secundário , Neoplasias Hepáticas/secundário , Neoplasias Pancreáticas/patologia , Neoplasias Cutâneas/secundário , Adenocarcinoma/patologia , Idoso , Biópsia , Biópsia por Agulha , Mama/patologia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Necrose Gordurosa/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Necrose , Pâncreas/patologia , Paniculite/patologia , Pele/patologia , Neoplasias Cutâneas/patologiaRESUMO
This is a retrospective study of 35 patients with spontaneous bacterial peritonitis and liver cirrhosis identified between 1981 and 1989. The mean age of all patients was 44 years, with a range of 16 to 68. Criteria for spontaneous bacterial peritonitis included either a positive ascites culture with a polymorphonuclear cell concentration greater than 250 cells per mm3 (18 cases) or a negative ascitic fluid culture with a polymorphonuclear cell count greater than 500 cells per mm3 and no evident intra-abdominal source of infection (17 cases). Twenty-one patients were male and 14 female. The most frequent presenting symptoms were abdominal pain and fever, noted in 20 (57%) and 19 (54%) patients, respectively, while 5 patients (14%) were completely asymptomatic. The overall mortality in this series was 54% (19 of 35 patients). The presence of encephalopathy or renal insufficiency was associated with a high mortality rate (73% and 87%, respectively). Encephalopathy was present in 67% of the non-survivors, but in only 25% of the survivors (p < 0.0025); likewise, renal failure was observed in 68% of the non-survivors, but in only 12.5% of those who survived (p < 0.001). The use of newer-generation cephalosporins and penicillins led to a diminished mortality (42%) as compared with that (64%) observed in patients treated with conventional antibiotic regimens.