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Biomedical subjects

R Wyllie

Publications and source records attributed to R Wyllie.

83 records · Page 5Linked to original sources
PubMed1979

Chronic diarrhea in infants and children.

A useful clinical classification of chronic diarrhea is based on the character of the stool--watery, fatty or bloody. Pathophysiologic mechanisms include osmotic and secretory diarrheas, bacterial overgrowth leading to excess colonic bile acids and fatty acids, defective anion exchange systems, mucosal damage and abnormal motility and transit. Evaluation may require hospitalization. Antidiarrheal agents are not used. Antibiotics are generally not indicated. Parenteral hydration and feedings of special formulas are carefully monitored.

Bile Acids and Salts↗
PubMedDate not supplied

Management of inflammatory bowel disease: 30 years of observation.

Management of inflammatory bowel disease has become more precise and effective in the last 30 years, ensuring long, productive lives for most patients. Data such as family history, duration of disease, the onset of complications, and type of therapy are presented from 450 patients with inflammatory bowel disease treated during a 10-year period ending in 1984. The incidence of general complications over three decades is compared. Perianal disease and intestinal obstructions dominate complications of Crohn's disease. The most common nongastrointestinal complication for patients with either disease is monarticular large joint arthritis. Approximately 75% of patients with Crohn's disease will eventually undergo surgery. In the first decade of data collection, 50% of patients with ulcerative colitis had surgery; in the second decade, 26%; and in the third decade, 39%. The changing percentages correspond initially to advances in medical therapy and then to advances in surgical therapy.

Adolescent↗
PubMedDate not supplied

Associated ulcerative colitis, sclerosing cholangitis, and insulin-dependent diabetes mellitus.

We report two young men with clinical and laboratory evidence of macroscopic ulcerative colitis, sclerosing cholangitis, and insulin-dependent diabetes mellitus. The first patient presented at age 15 with vomiting, abdominal pain, weight loss, and abnormal liver function test results. Liver biopsy and endoscopic retrograde cholangiopancreatography (ERCP) demonstrated sclerosing cholangitis. Colonoscopy with biopsy revealed ulcerative colitis which responded to sulfasalazine. Diabetes occurred at age 18 and insulin therapy was begun. The second patient was 19 at presentation with diarrhea, hematochezia, and weight loss. Proctosigmoidoscopy revealed ulcerative colitis, and sulfasalazine led to clinical remission. Three months later he developed diabetes requiring insulin therapy. At age 28, he developed elevated alkaline phosphatase, and ERCP revealed sclerosing cholangitis. At age 37 he expired from adenocarcinoma that metastasized to the liver. Literature review revealed only one possible case report of this association with microscopic asymptomatic ulcerative colitis in that patient. Statistical analysis suggests that this association is real rather than a chance occurrence. An autoimmune process may be involved and a specific histocompatibility locus antigen (HLA) type may exert a regulatory influence.

Adolescent↗