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Biomedical subjects

A Nakad

Publications and source records attributed to A Nakad.

14 recordsLinked to original sources
PubMed1998

Is early enteral nutrition in acute pancreatitis dangerous? About 20 patients fed by an endoscopically placed nasogastrojejunal tube.

Bowel rest during treatment of acute pancreatitis deprives the gut of nutrients and affects its structure and function. Enteral feeding is usually performed late in the course of acute pancreatitis and therefore cannot prevent intestinal barrier dysfunction and possible bacterial translocation. To assess the effect of early enteral nutrition we performed a prospective study on 21 patients (11 males/10 females) presenting with severe acute pancreatitis (13 biliary, 6 alcoholic, and 2 miscellaneous). Severity was established by a mean Ranson score of 3.57. All but one patient could be fed through a double-lumen nasogastrojejunal tube within 60 h after admission. No significant complication of the technique was observed. We conclude that early jejunal feeding can be used safely in severe acute pancreatitis. Further comparative studies are necessary to demonstrate any superiority to total parenteral nutrition.

Acute Disease↗
PubMed1989

Hyperamylasemia with papillary serous cystadenocarcinoma of the ovary.

High levels of serum amylase and CA19.9 were noted in a patient with papillary serous cystadenocarcinoma of the ovary. Electrophoresis identified isoamylases of salivary type. Both markers decreased rapidly after removal of the ovarian tumour. These considerations argue in favor of the early detection of amylase isoenzymes in patients in whom history, objective signs, and routine diagnostic studies fail to disclose a pancreatic disease.

Aged↗
PubMed1988

Prolonged cholestasis and disappearance of interlobular bile ducts following chlorpropamide and erythromycin ethylsuccinate. Case of drug interaction?

A 52-year-old man, having been treated for 4 months with chlorpropamide for diabetes mellitus type II, developed severe cholestatic hepatitis following a short course of erythromycin ethylsuccinate. Despite prompt withdrawal of both drugs, the cholestatic picture worsened and was associated with morphological evidence of disappearing interlobular bile ducts. After a 2-year course of profound cholestasis complicated by steatorrhea and striking hyperlipidemia, the patient died of ischemic cardiomyopathy. It is believed that this is the first published case of irreversible cholestasis with disappearance of ducts potentially related to a metabolic interaction between erythromycin ethylsuccinate and chlorpropamide.

Bile Ducts, Intrahepatic↗
PubMedDate not supplied

Quality of life assessment after Nissen fundoplication.

The aim of this study was to evaluate the quality of life of 31 patients presenting with gastroesophageal reflux (GORD) and operated on by Nissen fundoplication. The series consisted of 23 men and 8 women; the median age was 39 years (range 22-65) and the median follow-up 36 months (range 18-74). We used a new questionnaire: the Gastrointestinal Quality of Life Index (GIQLI) that includes 36 items and uses a five-graded Likert scale (from 0 to 4) giving a maximum score of 144. This score includes five dimensions: symptoms, emotions, vitality, social relations and medical treatment. The pre- and postoperative GIQLI scores observed in the Nissen group and the score of a control group of 110 healthy patients were compared with each other. The preoperative score (71 +/- 21) was greatly impaired compared to the score (123 +/- 13) of the control group (p < 0.0001). The postoperative score (109 +/- 21) increased significantly (p < 0.0001) but remained statistically inferior to the score of the control group (p < 0.005). The analysis of the dimensions showed that the postoperative score of the symptoms was lower in the Nissen group: 56 +/- 9 versus 66 +/- 6 in the control group (p < 0.0005) whereas no statistical difference was found for the four other dimensions. This lower symptoms score was not due to recurrence of GORD symptoms but to the occurrence of flatulence and to the persistence of gurgling noises and gas bloating. In conclusion, the quality of life of the patients requiring surgery for gastroesophageal reflux was greatly impaired, it largely improved after Nissen fundoplication but did not reach the level of healthy patients because of unrelated GORD gastrointestinal symptoms.

Adolescent↗
PubMedDate not supplied

[Is immunosuppressor treatment effective in lymphocytic gastritis? Apropos of a case associated with an intestinal lymphoma].

We report the case of a patient with "lymphocytic gastritis" surprisingly associated with an intestinal lymphoma which was treated after intestinal resection by corticosteroids and a combination of antimitotic agents. Comparing gastric mucosa before and 3 months after therapy, we observed a striking reduction of inflammation. Such a case suggests the possibility of a beneficial effect of immunosuppressive therapy on "lymphocytic gastritis" and favors the hypothesis of an immunological disorder.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Is jaundice a cause of error in the interpretation of CA 19-9 blood levels?].

Serum CA 19-9 has been proposed as a tumour marker for pancreatic cancer (PC). However, false positive results are seen in sera of patients with benign jaundice. The CA 19-9 assay was performed by a solid state radioimmunoassay in 86 icteric patients (total bilirubin greater than 2 mg/dl). 24/86 had PC (12 men, 12 women, mean age 74 years) and 62/86 had benign jaundice (29 men, 33 women, mean age 56 years; cirrhosis: n = 20, angiocholitis: n = 21, hepatitis: n = 21). At a cut-off level of 60 U./ml, for detecting icteric PC, sensitivity was 83%, and specificity was 79%. At 120 U./ml, sensitivity was 79%, but specificity was increased to 92%. We conclude that 21% of patients with benign jaundice had a CA 19-9 level greater than 60 U./ml, and using a CA 19-9 level of 120 U./ml, the specificity of the test to detect icteric PC was increased, with little decrease in the sensitivity.

Aged↗