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Biomedical subjects

A Mallory

Publications and source records attributed to A Mallory.

13 recordsLinked to original sources

Drug-induced pancreatitis.

We reviewed the English-language literature pertaining to drug-induced pancreatitis and attempted to determine whether the reported association between each drug and pancreatitis was valid. The following drugs seem to cause pancreatitis: azathioprine, chlorothiazide and hydrochlorothiazide, oestrogens, frusemide, 6-mercaptopurine, methyldopa, sulphonamides, sulindac, tetracycline and valproic acid. Less convincing but suggestive evidence exists for colaspase, chlorthalidone, combination cancer chemotherapy, cimetidine, cisplatin, corticosteroids, cytosine arabinoside, diphenoxylate, ethacrynic acid, iatrogenic hypercalcaemia, methandienone, metronidazole, nitrofurantoin, pentamidine, phenformin, piroxicam and procainamide. In general, pancreatitis is a very rare complication of treatment with these drugs. The pathogenesis of the pancreatitis is usually obscure, but is probably mediated by an immune response. Certain drugs such as oestrogens cause hypertriglyceridaemia, which in turn may lead to pancreatitis.

Drug-Related Side Effects and Adverse Reactions

Complications of diagnostic paracentesis in patients with liver disease.

A retrospective analysis of 242 consecutive diagnostic abdominal paracenteses in patients with liver disease disclosed seven major complications, including serious hemorrhage (four), perforation of bowel with generalized peritonitis (one), perforation of bowel with abdominal wall abscess (one), and a catheter fragment left in the abdominal wall or cavity (one). The results of this study emphasize the potential dangers of this procedure in these patients and raise the possibility that complications may be more common than previously thought.

Abdominal Muscles

Clinitest ingestion.

Eight patients who had ingested Clinitest tablets were seen in one hospital over four years. Nineteen reported cases were also reviewed. Clinitest ingestion seems to be more common than was thought. Gastric lesions are common, though the frequency of serious sequelae has been overestimated in reports. Some features of Clinitest ingestion differ from those produced by ingesting other alkalis. These include a higher frequency of adult and accidental ingestion, a lower prevalence of pharyngeal lesions, and oesophageal strictures that tend to be more proximal, shorter, and earlier in onset. The incidence of accidental ingestion by adults would probably be reduced if other methods of testing urine were used in patients who are likely to misunderstand instructions or mistake the tablets for others and if Clinitest tablets could be made in a distinctive size and shape.

Adolescent

Oral cholecystography after alcoholic pancreatitis.

Retrospective and prospective studies were done to evaluate the efficacy of oral cholecystography (OCG) performed before hospital discharge on alcoholic patients with acute pancreatitis. In the retrospective study, OCG adequately opacified the gallbladder in 21 of 26 patients (81%). Of the 5 patients with inadequate opacification, 1 was jaundiced at the time of OCG; the other 4 had OCG before resumption of solid food. In the prospective study, OCG done in nonjaundiced patients shortly after resumption of food yielded adequate opacification in 19 of 21 patients (90%) without gallstones. We conclude that in nonjaundiced alcoholic patients with acute pancreatitis not caused by gallstones, OCG performed after resumption of a solid diet and before hospital discharge is usually successful in opacifying the gallbladder.

Alcoholism

Persistent hypotension and intestinal infarction in a patient with primary amyloidosis.

A patient with primary amyloidosis and the nephrotic syndrome had diarrhea and gastrointestinal bleeding probably due to intestinal ischemia. He died with extensive intestinal infarction. The infarction was most likely caused by decreased splanchnic perfusion secondary to the chronic hypotension of the nephrotic syndrome and to amyloid deposition within the walls of the small blood vessels supplying the gut. Although amyloidosis was suspected prior to death, a fixation artifact probably prevented the correct antemortem biopsy diagnosis.

Aged

Typhoid at sea: epidemic aboard an ocean liner.

S. S. Oronsay steamed into Vancouver harbour on January 14, 1970 with an epidemic of typhoid on board. After three weeks in quarantine the ship sailed, the epidemic contained. Eighty-three sick crewmen and passengers were admitted to hospital with suspected typhoid. Control measures were so successful that no cases developed during the subsequent voyage of the ship, no secondary cases developed in Vancouver and only one of the passengers who disembarked in Vancouver came down with typhoid, contracted while on board.

Adult