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Biomedical subjects

S N Sullivan

Publications and source records attributed to S N Sullivan.

At least 19 recordsLinked to original sources
PubMed1992

Runners' diarrhea. Different patterns and associated factors.

One hundred and nine distance runners participated in a questionnaire survey of bowel function related to running. Thirteen (12%) had had fecal incontinence while running. Sixty-eight (62%) had stopped to have a bowel movement while training. Forty-seven (43%) had "nervous" diarrhea before competition and 13 (12%) had stopped during competition for a bowel movement. Fifty-one (47%) had experienced diarrhea after racing or hard runs and 17 (16%) had seen blood in their stool in the same situations. Runners who had nervous diarrhea before competition were more likely to have symptoms of milk intolerance and irregular bowel function when not exercising, and runners who had symptoms of the irritable bowel syndrome often had to stop for a bowel movement during training. Runners with diarrhea after racing or hard runs frequently experienced severe abdominal cramps, nausea and vomiting, and occasionally, rectal bleeding at the same time. Any form of "runners' diarrhea" was unrelated to age, previous intestinal infection or food poisoning, food allergies, or dietary fiber.

Adult↗
PubMed1992

Effects of erythromycin on gut transit in pseudo-obstruction due to hereditary coproporphyria.

We studied gastrointestinal transit in a 57-year-old man with chronic intestinal pseudo-obstruction along with peripheral and autonomic neuropathy due to hereditary coproporphyria and we evaluated the effects of acute and chronic therapy with erythromycin. Noninvasive scintigraphic studies of regional transit of solid residue through the gut were obtained before treatment, during the acute i.v. administration of 500 mg, every-8-h doses of erythromycin for 24 h and after 15 weeks of oral therapy (500 mg, three times daily). During acute i.v. administration, symptoms and transit measurements dramatically improved; however, all parameters and symptoms returned to pretreatment levels during chronic oral therapy. We conclude that hereditary coproporphyria with associated autonomic neuropathy results in significant delay in small bowel and colonic transit; chronic administration of 500 mg three times a day oral erythromycin was not associated with maintenance of the improvement in regional transit and symptoms observed following acute i.v. administration of the drug at the same dose.

Administration, Oral↗
PubMed1990

Thoracic succussion splash: a new symptom and sign of achalasia.

A patient with a "thoracic succussion splash" due to achalasia is described. She noted a splashing or sloshing sensation in her chest related to jogging and bending. On examination a splashing sound could be heard over the mid sternum and the posterior chest when the patient was rocked vigorously back and forth.

Adult↗
PubMed1987

The midclavicular line: a wandering landmark.

Although the midclavicular line (MCL) is the usual reference point for clinical assessment of liver size and localization of the cardiac apex beat, we found substantial interobserver variation in locating the MCL. The distance from the midline to the MCL as estimated by 20 clinicians in three subjects varied by up to 10 cm. More variation was found for estimates in the obese subject than for those in the two subjects of normal build (p = 0.004). No difference in variation was found between consultants and house staff. The limitations of the MCL as a reference point are discussed in light of these findings.

Cardiomegaly↗
PubMed1987

Sulfasalazine lung. Desensitization to sulfasalazine and treatment with acrylic coated 5-ASA and azodisalicylate.

A patient with ulcerative colitus developed fever, dyspnea, eosinophilia, and pulmonary infiltrates while taking sulfasalazine. The abnormalities resolved when the sulfasalazine was stopped but the colitus recurred. Desensitization to sulfasalazine was unsuccessful, but treatment with azodisalicylate (olsazine) controlled the colitus and did not cause pulmonary problems.

Adult↗
PubMed1986

The supersensitive hypertensive lower esophageal sphincter. Precipitation of pain by small doses of intravenous pentagastrin.

The clinical and investigative features of eight patients with attacks of epigastric pain believed due to a hypertensive lower esophageal sphincter (LES) are described. Radionuclide esophageal transit studies were normal in all but one patient. Two patients had positive acid perfusion studies. Only three had an abnormal baseline esophageal manometry, but after small intravenous doses of pentagastrin all subjects experienced their presenting pain coincident with increases in LES pressure ranging from 75 to 140 mmHg. Five patients eventually required surgical myotomy of the LES, but pain relief which was immediate and complete in all proved permanent in only one. Two of the operated patients continued to experience severe attacks of pain refractory to medical therapy. The diagnosis of a hypertensive LES is best made by pentagastrin stimulation of the sphincter, but cutting the sphincter may not cure the patient.

Adolescent↗
PubMed1986

Reduction by morphine of human postprandial insulin release is secondary to inhibition of gastrointestinal motility.

The effect of morphine (0.1 mg/kg) on insulin secretion stimulated by oral, intraduodenal, or intravenous administration of glucose was studied in seven healthy volunteers. When glucose was given intravenously, morphine had no effect on plasma glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP), or pancreatic glucagon. Following oral glucose, morphine slowed gastric emptying and reduced plasma concentrations of glucose, insulin, and GIP. During intraduodenal infusion of glucose, insulin concentrations in plasma were also decreased by morphine, an effect best explained by decreased small intestinal transit with delayed absorption of glucose and delayed release of GIP. We conclude that clinically relevant doses of morphine have no direct effect on insulin secretion and that the changes observed were secondary to slowed gastric emptying and small intestinal transit.

Adolescent↗
PubMed1985

Chest pain--esophageal, cardiac, or both?

The esophagus may be the origin of chest pain clinically indistinguishable from that of ischemic heart disease. In some patients the esophageal origin of the pain may only be recognized by pharmacological provocation during manometry. We describe nine patients with chest pain which could be explained by disorders of esophageal motility--diffuse spasm in four, high pressure lower esophageal sphincter in three, and "nutcracker esophagus" in two. Methacholine provoked the pain and manometric abnormalities in five patients who had normal baseline tracings. However, seven patients given methacholine developed ischemic changes on the electrocardiogram. In one patient these were typical of Prinzmetal's variant angina. The manometric and electrocardiographic abnormalities were reversed by intravenous atropine. Ischemic heart disease and esophageal motor disorders may occur concomitantly and pose a dilemma in diagnosis and management.

Aged↗
PubMed1983

Hemobilia after percutaneous liver biopsy: role of endoscopic retrograde cholangiopancreatography and sphincterotomy.

Hemobilia is a rare complication of percutaneous liver biopsy. We present such a case that demonstrates the usefulness of endoscopic retrograde cholangiopancreatography in establishing the diagnosis, the importance of localization of the bleeding site by angiography, and the therapeutic usefulness of arterial embolization for the control of persistent bleeding. Also, we propose a possible indication for endoscopic sphincterotomy in the rare case where retained intrabiliary blood clot causes progressive obstructive jaundice complicated by severe pain and sepsis.

Adult↗