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Biomedical subjects

V A DeLuca

Publications and source records attributed to V A DeLuca.

At least 19 recordsLinked to original sources
PubMed1990

Endoscopic treatment of Dieulafoy's lesion of the duodenum.

Dieulafoy's lesion is an often unrecognized cause of catastrophic upper gastrointestinal hemorrhage, typically seen in otherwise asymptomatic patients. Although the lesion is most often found in the stomach, it has rarely been reported to occur in the jejunum and duodenum. Endoscopic treatment has recently been attempted to arrest the bleeding from these lesions, when found in the stomach, with satisfactory results. We report a patient with a bleeding duodenal Dieulafoy lesion who was successfully treated with endoscopic injection of epinephrine (1:10,000) and electrocoagulation. Endoscopic treatment of Dieulafoy's lesion should be attempted before surgery and, as in other causes of acute nonvariceal hemorrhage, be considered the treatment of choice.

Aged↗
PubMed1989

No acid, no polys--no "active" gastritis, no dyspepsia. A proposal.

The current dilemma in characterizing non-ulcer dyspepsia (NUD) is due to the very nature of the term which has forced the dependence for diagnosis primarily on symptomatology and the absence of an ulcer crater as ascertained by radiographs or endoscopy. I propose a new classification which I believe is consistent and well founded, based on the presence of histologic gastritis and acid secretion of the stomach. Four categories are presented: (a) normal histology, (b) "active" gastritis, (c) "inactive" gastritis, and (d) atrophic gastritis with achlorhydria. Acid secretion is present in categories a-c. The classification is dependent on the presence of the "poly" to denote active gastritis, round cells to classify inactive gastritis, and the loss of parietal and chief cells with achlorhydria to define gastric atrophy. I propose that polys and acid, which characterize active gastritis, are necessary for producing dyspepsia and/or gastroduodenal mucosal injury, and provide a rationale for treatment. The accepted causes of active gastritis include acid-peptic disease, Campylobacter pylori, and aspirin/nonsteroidal anti-inflammatory drug (NSAID) medication.

Achlorhydria↗
PubMed1986

A multicenter study of ranitidine treatment of duodenal ulcers in the United States.

Treatment of duodenal ulcer with the histamine H2-receptor antagonist, ranitidine, was assessed in a double-blind, randomized, multicenter trial in which patients were treated for two consecutive 4-week periods with ranitidine 150 mg b.i.d. or a placebo. All patients were allowed to take antacids as necessary for symptoms. Three hundred eighty-two patients were entered and 355 completed the first 4-week trial period. Ranitidine significantly improved healing at 2 weeks (37 versus 19%, p less than 0.01) and at 4 weeks (73 versus 45%, p less than 0.01), with better relief of pain and lower use of antacids. In the second 4-week trial period, 124 unhealed patients from the first 4 weeks were re-randomized. Ranitidine treatment resulted in a greater healing rate regardless of previous treatment (p less than 0.05). In this trial, side effects were uncommon and not different between placebo and the tested drug. One case of hepatitis in the ranitidine treated group was presumed on the evidence to be non-A non-B. Ranitidine is effective and appears to be safe in the treatment of duodenal ulcer and its symptoms.

Adult↗
PubMed1985

Sulfasalazine-induced pulmonary disease.

Sulfasalazine has been widely used in the treatment of inflammatory bowel disease. Although a high incidence of side effects has been reported, pulmonary complications are rare. The clinical, radiographic, and histological abnormalities that occurred in a patient three months after initiation of sulfasalazine are described. A review of the literature suggests that the possibility of drug-induced pulmonary disease should be considered in any patient with inflammatory bowel disease receiving treatment with sulfasalazine who develops symptoms or radiographic evidence of pulmonary disease. Transbronchial biopsy may be useful in confirming the type of pulmonary injury.

Aged↗
PubMed1981

Hydrogen peroxide colitis: a report of three patients.

We have seen three patients with acute ulcerative colitis after hydrogen peroxide enemas. The colitis is probably the result of the explosive entrance of gas into the loose connective tissues of the mucosa and submucosa of the rectum and sigmoid. Fortunately, it is transitory in nature, but it should be distinguished from ulcerative, ischemic, or pseudomembranous colitis.

Adult↗
PubMed1981

Is gastroduodenitis part of the spectrum of peptic ulcer disease?

Gastroduodenitis should be included with duodenal ulcer and gastric ulcer in the spectrum of clinical disorders that have different pathogenetic mechanisms but a similar clinical picture. Published results of a clinical, endoscopic, radiologic, and histologic study of 100 patients presenting with gastrointestinal symptoms revealed that 61% had classic and 39% had atypical manifestations of peptic ulcer disease. We could not clinically distinguish the 24 patients with ulcer crater (40% of the classic group) from the 25 patients with acute gastroduodenitis without crater (41% of the classic group). Preliminary data of a prospective study compared the treatment responses of 19 patients with gastroduodenitis and 39 patients with peptic ulcer disease. These patients were diagnosed endoscopically and restudied after treatment with a bland diet and antacids seven times per day for 8 weeks. The responses to therapy in gastroduodenitis and peptic ulcer were as follows: endoscopically, 63 and 80%, respectively; histologically, 74 and 65%, respectively; symptomatically, 47 and 65%, respectively. Preliminary data on the duodenal epithelial thymidine uptake revealed an increased proliferative index in duodenitis patients but not in patients with peptic ulcer or control subjects.

Adult↗