Biomedical subjects
T A LoIudice
Publications and source records attributed to T A LoIudice.
Gastric obstruction from the Angelchik prosthesis.
A 47-year-old woman with gastroesophageal reflux underwent insertion of an angelchik antireflux prosthesis. Five days postoperatively, the prosthesis had slipped and obstructed the stomach, requiring reoperation.
Hepatic dysfunction due to intravenous abuse of methylphenidate hydrochloride.
Methylphenidate-induced hepatic injury was documented by abnormal liver function tests including a markedly elevated serum bilirubin, serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic transaminase. Liver biopsy confirmed portal inflammation and hepatocellular disarray. Enzyme changes were reproducible with rechallenge of the drug (Ritalin). The drug is capable of producing hepatic injury, particularly when given in nonstandard doses intravenously.
Cimetidine in the treatment of gastric ulcer induced by steroidal and nonsteroidal anti-inflammatory agents.
The study of a group of patients with gastric ulcers induced by anti-inflammatory agents, was undertaken in an attempt to ascertain the effectiveness of cimetidine (Tagamet) when compared with intensified doses of antacids in their treatment. Seventy patients with medication-induced benign gastric ulcers confirmed by endoscopy and biopsy were studied. The agents principally responsible were aspirin, prednisone, ibuprofen, indomethacin, and sulindac in standard pharmacologic doses. The study was carefully controlled to exclude confusing parameters. Patients were divided into two groups. Group 1 (38 patients) received cimetidine plus and antacid (Maalox). Group 11 (32 patients) received placebo tablets plus the same dose of antacid as in Group 1. All anti-inflammatory agents were discontinued and patients were instructed to avoid known gastric irritants. Treatment periods lasted six weeks. Confirmation of healing was by endoscopic evaluation. A significant difference was noted only with respect to treatment response. Twenty-five of the 38 patients (65.7%) in group 1 receiving cimetidine plus antacid had their ulcers healed within the six-week period. Only eight of the 32 patients (25%) in Group 11 receiving placebo plus antacid had ulcer healing within this period of time (P less than .001). We conclude that a regimen of cimetidine plus intensified antacid therapy is far superior to the same dose of antacid alone in the treatment of gastric ulcer induced by anti-inflammatory agents.
Submucous lipoma simulating carcinoma of the colon.
A 43-year-old white man who presented for evaluation of hematochezia was found to have an abdominal mass in the proximal descending colon, suggestive of carcinoma on barium enema and at colonoscopy. Surgery revealed a submucous lipoma. We report the case to show that submucous lipomas may be mistaken for carcinoma of the colon.
Pregnancy and jejunoileal bypass: treatment of complications with total parenteral nutrition.
A 27-year-old pregnant woman with a jejunoileal bypass presented with intractable nausea, vomiting, and diarrhea during the 25th week of gestation. Total parenteral nutrition supported mother and fetus through a difficult portion of the pregnancy, with a successful outcome.
[Diminished peritoneal pain perception in patients with liver cirrhosis and ascites].
Complete loss of parietal peritoneal sensitivity observed in a patient with long-standing ascites secondary to cirrhosis of the liver prompted an investigation of peritoneal sensitivity in 22 patients with the same condition. In all of them a decrease of the peritoneal sensitivity to needle perforation was found. All perceived peritoneal perforation as less painful than perforation of the abdominal skin by the same needle. In 8 control patients perforation of the peritoneum caused more discomfort than the perforation of the skin. In 7 cirrhotic patients where a histologic examination of the parietal peritoneum was available a chronic fibrotic peritonitis was present. Peritoneal insensitivity may partly account for mild abdominal symptoms in cirrhotics developing bacterial peritonitis.
Tolazamide-induced hepatic dysfunction.
A case of tolazamide-induced hepatic injury is reported. Injury was documented by abnormal liver tests, including an elevated alkaline phosphatase, 5' nucleotidase and serum glutamic oxaloacetic transaminase. Liver biopsy confirmed the degree and type of injury which consisted of severe portal inflammation, bile duct proliferation and early fibrosis. The case is reported to further establish tolazamide as a drug capable of producing hepatic injury and to report a new form of hepatic injury attributable to a sulfonylurea agent.
Malabsorption in infectious mononucleosis.
A case of infectious mononucleosis, complicated by malabsorption, is presented. Malabsorption was documented by abnormal d-xylose, small bowel series, 72-hour stool fat and jejunal biopsy. Small bowel abnormalities and other gastrointestinal manifestations of infectious mononucleosis are discussed.