Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event.Both non-pharmacological and ...Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event.Both non-pharmacological and pharmacological treatment options are available to treat hypertension.Yoga,recently received more attention as a treatment modality for various lifestyle disorders,even though practiced in India since ancient times.In this review,we are analyzing the role of yoga in the treatment of systemic hypertension.展开更多
INTRODUCTIONThe“nonspecific” inflammatory bowel diseases ,ulcerative colitis and Crohn,s represent a group of heterogeneous inflammatory and ulcerative disases of the small and large intestines of unknown etiology ,...INTRODUCTIONThe“nonspecific” inflammatory bowel diseases ,ulcerative colitis and Crohn,s represent a group of heterogeneous inflammatory and ulcerative disases of the small and large intestines of unknown etiology ,associated with many gastrointestinal and systemic complications .Appearing initially as isolated cases in Great Britain and northern Europe during the 19th and early 20th centuries ,they have steadily increased numerically and geographically and today are recognized worldwide.展开更多
INTRODUCTIONOf the three cardinal manifestations of chronic pancreatitis-pain,diabetes mellitus and steatorrhea,it is pain thatbrings the patient to the physician and is the most difficultto manage.The intractabale pa...INTRODUCTIONOf the three cardinal manifestations of chronic pancreatitis-pain,diabetes mellitus and steatorrhea,it is pain thatbrings the patient to the physician and is the most difficultto manage.The intractabale pain that is quite展开更多
Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The only way to prevent this complication is to avoid an ERCP all together. Because of the risks involved, a...Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The only way to prevent this complication is to avoid an ERCP all together. Because of the risks involved, a careful consideration should be given to the indication for ERCP and the potential risk/benefit ratio of the test. Once a decision to perform an ERCP is made, the procedure should be carried out with meticulous care by an experienced endoscopist, and with a minimum of pancreatic duct opacification. Several pharmacologic agents have been tested, but to date the most important method of reducing post ERCP pancreatitis is the placement of pancreatic stent. Pancreatic stents should be placed in all patients at high risk of this complication such as those undergoing pancreatic sphincterotomy, pancreatic duct manipulation and intervention, and patients with suspected sphincter of Oddi dysfunction. Pancreatic stents should be also considered in patients requiring precut sphincterotomy to gain biliary access.展开更多
New once daily mesalamine formulations may improve adherence to medication usage.Response to Asacol and other forms of 5-aminosalicyclic acid(5-ASA)is better correlated with tissue concentrations and best predicted by...New once daily mesalamine formulations may improve adherence to medication usage.Response to Asacol and other forms of 5-aminosalicyclic acid(5-ASA)is better correlated with tissue concentrations and best predicted by concentrations of the drug within the lumen of the colon.Our group used computer simulation to predict colonic 5-ASA levels after Asacol administration.In our study,the model simulated Asacol distribution in the healthy colon,and during quiescent and active ulcerative colitis.An Asacol dosage of 800 mg,threetimes a day,was compared to 2400 mg given once a day.Under ideal conditions,the predicted maximum drug in the total colon and individual colonic segments over 100 d differed by less than 3%between single and multiple doses.Despite changes in motility and defection rates,the predicted maximum and average 5-ASA concentrations in the total colon and individual colonic segments differed by less than 10%between dosing regimens.Asymmetric distribution of 5-ASA in the colon was influenced by frequency of bowel movements and colonic transit rate.In active colitis,sigmoid 5-ASA concentration becomes negligible.Our model supports once daily administration of Asacol as standard treatment for ulcerative colitis.展开更多
Introduction Serious, life threatening infections, areusually due to Gram negative aerobic bac-teria. Septicaemia with shock may developunless prompt effective treatment is insti-tuted. Aminoglycosides used to be
The limits of medicine have not yet been reached. Numerous human illnesses initially thought to be incurable are reversible under unique and unpredictable individual circumstances.This paper, and the preceding compani...The limits of medicine have not yet been reached. Numerous human illnesses initially thought to be incurable are reversible under unique and unpredictable individual circumstances.This paper, and the preceding companion publication,describes instances of the successful treatment of patients previously labeled as untreatable, including instances of severe ulcerative colitis and Crohn's disease.展开更多
An extract (G-INH) made from mature human granulocytes freshly isolated from normai blood causes human neutrophils to undergo apoptosis in vitro as shown by morphologic changes and by the typical ladder pattern of sma...An extract (G-INH) made from mature human granulocytes freshly isolated from normai blood causes human neutrophils to undergo apoptosis in vitro as shown by morphologic changes and by the typical ladder pattern of small DNA fragments noted on agarose gel electrophoresis of isolated DNA. Apoptosis occurs in from 20% to 30% of neutrophils over 24 hours of culture in vitro and the addition of G-INH to the medium causes a dose-related increase in the incidence of apoptosis. Heating G-INH at 60t for 30 minutes does not destroy its capacity to induce apoptosis but GM-CSF, G-CSF, and to a lesser extent IL-1β, antagonize this action. IL-3 does not diminish G-INH induced apoptosis of neutrophils. Substances, released from, mature neutrophils may participate in regulating the survival of other neutrophils, particularly in sites where the cells are in close proximity as in the marrow. Self destruction of post-mitotic neutrophils in marrow may thus represent an-other level at which regulation of cell production展开更多
In a May-issue of the World Journal of Gastroenterology, there is a very interesting study by Bruno et al. on erythropoietin (EPO) levels in patients with chronic liver disease. We have very recently reported a simila...In a May-issue of the World Journal of Gastroenterology, there is a very interesting study by Bruno et al. on erythropoietin (EPO) levels in patients with chronic liver disease. We have very recently reported a similar, but much larger study by Tacke et al. on the role of EPO in chronic liver disease. By comparing Bruno's results with our patient cohort and applying their展开更多
The benefits of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) beyond blood pressure reduction have been proven through many large studies (HOPE, LIFE) in high risk CVD patie... The benefits of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) beyond blood pressure reduction have been proven through many large studies (HOPE, LIFE) in high risk CVD patients;1 post hoc studies have shown reductions in new onset type 2 diabetes mellitus (DM). ……展开更多
Awareness of the digestive system began with the dawn of civilization, when man observing the feeding habits of animalsin the surrounding environment, experimented with foods, edible and inedible. Identity came with d...Awareness of the digestive system began with the dawn of civilization, when man observing the feeding habits of animalsin the surrounding environment, experimented with foods, edible and inedible. Identity came with discoveries of the digestive organs during the 16^th and 17^th centuries. Function was revealed by physiologic studies of digestion, absorption and secretion, metabolism, and motility during the 18^th and 19^th centuries. Diagnostic access improved with the technological advances of the 20^th century. Understanding of gastrointestinal (GI) disease followed growth of the basic sciences and gastroenterology's increased involvement in scientific research during the 20^th century.展开更多
Emphysematous cholecystitis is a rare subtype of acute cholecystitis characterized by the presence of gas in the gallbladder wall secondary to ischemia. Typically, this is a result of cystic artery vascular compromise...Emphysematous cholecystitis is a rare subtype of acute cholecystitis characterized by the presence of gas in the gallbladder wall secondary to ischemia. Typically, this is a result of cystic artery vascular compromise with a concomitant infection from gas-forming organisms such as Clostridium species, Klebsiella species, or Escherichia coli. The mortality rate of acute emphysematous cholecystitis is 15% - 20% compared with 1.4% in uncomplicated acute cholecystitis. The subsequent development of a cholecystocutaneous fistula, an abnormal connection between the gallbladder and the skin, is also a rare complication of gallbladder disease. We describe a case of a 77-year-old male who presented with right flank necrotizing fasciitis which developed from a cholecystocutaneous fistula secondary to emphysematous cholecystitis. Once the necrotic tissues were adequately debrided, the large open wound was treated with negative pressure wound therapy with instillation (NPWT-i) utilizing hypochlorous acid (HOCL). The wound was closed with a split-thickness skin graft.展开更多
It is of interest in an era of increasing biomedical sophisticaton to recall that a relatively short time ago, early in the 20th century, ‘simple' ulcerative colitis was an obscure ‘medical curiosity' emergi...It is of interest in an era of increasing biomedical sophisticaton to recall that a relatively short time ago, early in the 20th century, ‘simple' ulcerative colitis was an obscure ‘medical curiosity' emerging slowly from an unknown past. Crohn's disease was yet unidentified as a separate entity although careful review of the IBD literature documented its early presence, masquerading as ‘intestinal tuberculosis'. Into the 1930s, the etiology and pathogenesis of ulcerative colitis and Crohn's disease were unknown, and investigative hypotheses were scarce. Therapeutic resources were limited and treatment was primitive. At a time of limited biomedical knowledge and minimal clinical awareness, unsubstantiated views prevailed, including ‘vague reactions to foods' (sugar,margarine, corn flakes), deficiency of a ‘protective factor'in pig intestine, and psychiatric disease.展开更多
AIM: To report present state of iatrogenic drug-induced esophageal injury (DIEI) induced by medications in a private clinic.METHODS: Iatrogenic drug-induced esophageal injury (DIEI) induced by medications has been mor...AIM: To report present state of iatrogenic drug-induced esophageal injury (DIEI) induced by medications in a private clinic.METHODS: Iatrogenic drug-induced esophageal injury (DIEI) induced by medications has been more frequently reported. In a private clinic we encountered 36 cases of esophageal ulcerations complicating doxycycline therapy in a mainly younger Saudi population (median age 29 years).RESULTS: The most frequent presenting symptoms were oclynophagia, retrostemal burning pain and dysphagia (94 %,75 % and 56 %, respectively). The diagnosis was according to medical history and confirmed by endoscopy in all patients.Beside withdrawal of doxycycline, when feasible, all patients were treated with a proton-pump inhibitor (PPI) and a prokinetic. Thirty patients who reported to the clinic after treatment were improved within 1-7 (median 1.7) days.CONCLUSION: Esophageal ulceration has to be suspected in younger patients with odynophagia, retrosternal burning pain and/or clysphagia during the treatment with doxycycline.展开更多
Background: Metastatic breast cancer (MBC) is an incurable disease. The medium survival of MBC is 2-3 years with the aim of treatment focusing on symptom control and quality of life (QOL). Despite the availability of
文摘Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event.Both non-pharmacological and pharmacological treatment options are available to treat hypertension.Yoga,recently received more attention as a treatment modality for various lifestyle disorders,even though practiced in India since ancient times.In this review,we are analyzing the role of yoga in the treatment of systemic hypertension.
文摘INTRODUCTIONThe“nonspecific” inflammatory bowel diseases ,ulcerative colitis and Crohn,s represent a group of heterogeneous inflammatory and ulcerative disases of the small and large intestines of unknown etiology ,associated with many gastrointestinal and systemic complications .Appearing initially as isolated cases in Great Britain and northern Europe during the 19th and early 20th centuries ,they have steadily increased numerically and geographically and today are recognized worldwide.
文摘INTRODUCTIONOf the three cardinal manifestations of chronic pancreatitis-pain,diabetes mellitus and steatorrhea,it is pain thatbrings the patient to the physician and is the most difficultto manage.The intractabale pain that is quite
文摘Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The only way to prevent this complication is to avoid an ERCP all together. Because of the risks involved, a careful consideration should be given to the indication for ERCP and the potential risk/benefit ratio of the test. Once a decision to perform an ERCP is made, the procedure should be carried out with meticulous care by an experienced endoscopist, and with a minimum of pancreatic duct opacification. Several pharmacologic agents have been tested, but to date the most important method of reducing post ERCP pancreatitis is the placement of pancreatic stent. Pancreatic stents should be placed in all patients at high risk of this complication such as those undergoing pancreatic sphincterotomy, pancreatic duct manipulation and intervention, and patients with suspected sphincter of Oddi dysfunction. Pancreatic stents should be also considered in patients requiring precut sphincterotomy to gain biliary access.
文摘New once daily mesalamine formulations may improve adherence to medication usage.Response to Asacol and other forms of 5-aminosalicyclic acid(5-ASA)is better correlated with tissue concentrations and best predicted by concentrations of the drug within the lumen of the colon.Our group used computer simulation to predict colonic 5-ASA levels after Asacol administration.In our study,the model simulated Asacol distribution in the healthy colon,and during quiescent and active ulcerative colitis.An Asacol dosage of 800 mg,threetimes a day,was compared to 2400 mg given once a day.Under ideal conditions,the predicted maximum drug in the total colon and individual colonic segments over 100 d differed by less than 3%between single and multiple doses.Despite changes in motility and defection rates,the predicted maximum and average 5-ASA concentrations in the total colon and individual colonic segments differed by less than 10%between dosing regimens.Asymmetric distribution of 5-ASA in the colon was influenced by frequency of bowel movements and colonic transit rate.In active colitis,sigmoid 5-ASA concentration becomes negligible.Our model supports once daily administration of Asacol as standard treatment for ulcerative colitis.
文摘Introduction Serious, life threatening infections, areusually due to Gram negative aerobic bac-teria. Septicaemia with shock may developunless prompt effective treatment is insti-tuted. Aminoglycosides used to be
文摘The limits of medicine have not yet been reached. Numerous human illnesses initially thought to be incurable are reversible under unique and unpredictable individual circumstances.This paper, and the preceding companion publication,describes instances of the successful treatment of patients previously labeled as untreatable, including instances of severe ulcerative colitis and Crohn's disease.
基金Rothrock Research Fund in Hematology, The authors appreclate the assistance of supervising technicina, Linda Russ.Ulrica Stenheimer-Caudle, Sandra Peffly, and Marie Hyde.
文摘An extract (G-INH) made from mature human granulocytes freshly isolated from normai blood causes human neutrophils to undergo apoptosis in vitro as shown by morphologic changes and by the typical ladder pattern of small DNA fragments noted on agarose gel electrophoresis of isolated DNA. Apoptosis occurs in from 20% to 30% of neutrophils over 24 hours of culture in vitro and the addition of G-INH to the medium causes a dose-related increase in the incidence of apoptosis. Heating G-INH at 60t for 30 minutes does not destroy its capacity to induce apoptosis but GM-CSF, G-CSF, and to a lesser extent IL-1β, antagonize this action. IL-3 does not diminish G-INH induced apoptosis of neutrophils. Substances, released from, mature neutrophils may participate in regulating the survival of other neutrophils, particularly in sites where the cells are in close proximity as in the marrow. Self destruction of post-mitotic neutrophils in marrow may thus represent an-other level at which regulation of cell production
文摘In a May-issue of the World Journal of Gastroenterology, there is a very interesting study by Bruno et al. on erythropoietin (EPO) levels in patients with chronic liver disease. We have very recently reported a similar, but much larger study by Tacke et al. on the role of EPO in chronic liver disease. By comparing Bruno's results with our patient cohort and applying their
文摘 The benefits of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) beyond blood pressure reduction have been proven through many large studies (HOPE, LIFE) in high risk CVD patients;1 post hoc studies have shown reductions in new onset type 2 diabetes mellitus (DM). ……
文摘Awareness of the digestive system began with the dawn of civilization, when man observing the feeding habits of animalsin the surrounding environment, experimented with foods, edible and inedible. Identity came with discoveries of the digestive organs during the 16^th and 17^th centuries. Function was revealed by physiologic studies of digestion, absorption and secretion, metabolism, and motility during the 18^th and 19^th centuries. Diagnostic access improved with the technological advances of the 20^th century. Understanding of gastrointestinal (GI) disease followed growth of the basic sciences and gastroenterology's increased involvement in scientific research during the 20^th century.
文摘Emphysematous cholecystitis is a rare subtype of acute cholecystitis characterized by the presence of gas in the gallbladder wall secondary to ischemia. Typically, this is a result of cystic artery vascular compromise with a concomitant infection from gas-forming organisms such as Clostridium species, Klebsiella species, or Escherichia coli. The mortality rate of acute emphysematous cholecystitis is 15% - 20% compared with 1.4% in uncomplicated acute cholecystitis. The subsequent development of a cholecystocutaneous fistula, an abnormal connection between the gallbladder and the skin, is also a rare complication of gallbladder disease. We describe a case of a 77-year-old male who presented with right flank necrotizing fasciitis which developed from a cholecystocutaneous fistula secondary to emphysematous cholecystitis. Once the necrotic tissues were adequately debrided, the large open wound was treated with negative pressure wound therapy with instillation (NPWT-i) utilizing hypochlorous acid (HOCL). The wound was closed with a split-thickness skin graft.
文摘It is of interest in an era of increasing biomedical sophisticaton to recall that a relatively short time ago, early in the 20th century, ‘simple' ulcerative colitis was an obscure ‘medical curiosity' emerging slowly from an unknown past. Crohn's disease was yet unidentified as a separate entity although careful review of the IBD literature documented its early presence, masquerading as ‘intestinal tuberculosis'. Into the 1930s, the etiology and pathogenesis of ulcerative colitis and Crohn's disease were unknown, and investigative hypotheses were scarce. Therapeutic resources were limited and treatment was primitive. At a time of limited biomedical knowledge and minimal clinical awareness, unsubstantiated views prevailed, including ‘vague reactions to foods' (sugar,margarine, corn flakes), deficiency of a ‘protective factor'in pig intestine, and psychiatric disease.
文摘AIM: To report present state of iatrogenic drug-induced esophageal injury (DIEI) induced by medications in a private clinic.METHODS: Iatrogenic drug-induced esophageal injury (DIEI) induced by medications has been more frequently reported. In a private clinic we encountered 36 cases of esophageal ulcerations complicating doxycycline therapy in a mainly younger Saudi population (median age 29 years).RESULTS: The most frequent presenting symptoms were oclynophagia, retrostemal burning pain and dysphagia (94 %,75 % and 56 %, respectively). The diagnosis was according to medical history and confirmed by endoscopy in all patients.Beside withdrawal of doxycycline, when feasible, all patients were treated with a proton-pump inhibitor (PPI) and a prokinetic. Thirty patients who reported to the clinic after treatment were improved within 1-7 (median 1.7) days.CONCLUSION: Esophageal ulceration has to be suspected in younger patients with odynophagia, retrosternal burning pain and/or clysphagia during the treatment with doxycycline.
文摘Background: Metastatic breast cancer (MBC) is an incurable disease. The medium survival of MBC is 2-3 years with the aim of treatment focusing on symptom control and quality of life (QOL). Despite the availability of
