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Colorectal Neoplasms↗
Biomedical subjects
A Avots-Avotins
Publications and source records attributed to A Avots-Avotins.
Age does not influence acute aspirin-induced gastric mucosal damage.
Gastroduodenal ulceration and complications occur more commonly in elderly patients consuming aspirin and other nonsteroidal antiinflammatory drugs than in younger cohorts. To test the hypothesis that the gastroduodenal mucosa of the elderly is more sensitive to nonsteroidal antiinflammatory drug damage, acetylsalicylic acid in low (325 mg) and high (1300 mg) doses was administered on separate days to 10 elderly (median age, 67.5; range, 60-74 years) and 10 young (median age, 24.5; range, 19-30 years) healthy, male volunteer subjects. Gastroduodenal mucosal damage was assessed 2 hours after aspirin dosage by video-endoscopic techniques. At the conclusion of the study, the videotapes of all procedures were randomly evaluated by two endoscopists blinded to subject identification or study sequence. Endoscopically observed lesions were counted in the duodenum, gastric antrum, and gastric body. Aspirin damage was dose-related and more severe in the stomach than in the duodenum. There were no significant differences in total gastroduodenal lesion counts between age groups. In addition, no differences in median gastric pH or tissue 6-ketoprostaglandin F1 alpha content were observed between age groups. These data suggest that age is not a significant factor in determining the extent of acutely administered aspirin-induced damage.
6-Ketoprostaglandin F1 alpha↗
The effect of an elemental diet with and without gluten on disease activity in dermatitis herpetiformis.
Elemental diets are reported to decrease activity of patients with dermatitis herpetiformis. We tested the hypothesis that gluten, given in addition to an elemental diet, is responsible for the intestinal abnormalities, cutaneous immunoreactant deposition, and skin disease activity in dermatitis herpetiformis. At entry eight patients with dermatitis herpetiformis, who were consuming unrestricted diets, were stabilized on their suppressive medications at dosage levels that allowed individual lesions to erupt. Six patients were then given an elemental diet plus 30 of gluten for 2 weeks, followed by the elemental diet alone for 2 weeks. Conversely, two patients received an elemental diet alone for 2 weeks followed by an elemental diet plus gluten during the final 2 weeks. Small bowel biopsies, skin biopsies, and clinical assessments were done at 0, 2, and 4 weeks. Suppressive medication dose requirement decreased over the 4 weeks by a mean of 66%. Six of eight subjects significantly improved clinically during the gluten-challenge phase of the elemental diet and all were improved at the end of the study. The amount of IgA in perilesional skin did not change significantly, but the amount of C3 increased in five of seven evaluable subjects after gluten challenge. Circulating anti-gluten and anti-endomysial antibodies were not significantly affected by the diets. All subjects completing evaluable small bowel biopsies (seven of seven) demonstrated worsening of their villus architecture (by scanning electron microscopy and intraepithelial lymphocyte counts) during gluten challenge and improvement (six of six subjects) after 2 weeks of elemental dietary intake. We conclude that 1) there is a significant improvement in clinical disease activity on an elemental diet, independent of gluten administration, 2) small bowel morphology improves rapidly on an elemental diet, and 3) complement deposition but neither IgA deposition nor circulating antibody levels correlate with gluten intake. It seems likely that dietary factors other than gluten are important in the pathogenesis of the skin lesions in dermatitis herpetiformis.
Adult↗
Clinical utility of endoscopic ultrasound-guided fine needle aspiration.
OBJECTIVE: To assess our institution's initial experience with the clinical utility of endoscopic ultrasound (EUS)-guided fine needle aspiration. STUDY DESIGN: Prospective analysis of the clinical utility of EUS-guided FNA. RESULTS: Fifty-three patients underwent EUS-guided FNA of 64 sites, 28 for pancreatic masses, 15 for lymph nodes, 10 for solid lesions, 7 for cystic masses, 2 for submucosal masses and 2 for perigastrointestinal fluid. A cytopathologist was present during all procedures. An average of four passes (range, one to nine) was required to make a diagnosis in the 22 patients with pancreatic malignancies. There was one possible complication among the 53 patients. In 36 of the 53 patients, the combination of diagnostic EUS findings and cytologic diagnosis made a major change in the patient's management. CONCLUSION: Because of its ability to affect patient management, EUS-guided FNA will become a more commonly used procedure, especially at oncologic centers. Since the number of fine needle passes needed for diagnosis is quite variable, it is important to have a cytopathologist participate in these procedures.
Abdominal Neoplasms↗