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Cow's milk as a cause of infantile colic in breast-fed infants.
18 mothers of 19 breast-fed infants with infantile colic were put on a diet free of cow's-milk protein. The colic disappeared promptly from 13; in 12, it reappeared on at least two further indirect challenges (in the form of a diet containing cow's milk to the mother). Most infants became symptom-free at age 2 to 4 months; at 4 months, only 4 reacted with colic when the mother took cow's milk. 5 infants were directly challenged with cow's milk; 4 reacted promptly with colic. Other signs of intolerance to cow's-milk protein developed in 3 infants during weaning. The treatment of infantile colic in breast-fed infants by a diet free of cow's milk for the mother appears worthwhile.
Gastro-colic fistula complicating benign gastric ulcer in analgesic abusers.
Two cases of gastro-colic fistula occurring in analgesic abusers are described. In both patients, the fistulous communication was diagnosed at endoscopy and subsequently verified by upper gastrointestinal tract barium studies. Gastro-colic fistula is a rare complication of benign peptic ulcer disease. Whilst salcylates and cortico-steroids have been implicated as aetiological agents, abuse of compound analgesics has not previously been reported. Since the first description of gastro-colic fistula in 1755, thirty documented cases associated with benign gastric ulcer have been reported. Most often, gastro-colic fistula occurs secondary to gastric or colonic malignancy. Barium enema examination is the most accurate diagnostic study. Endoscopy has been confined to the visual inspection of the ulcer and establishing the benign nature of these lesions.
Butorphanol and meperidine compared in patients with acute ureteral colic.
Pain relief was evaluated in 81 patients with acute ureteral colic and the confirmed presence of a calculus. A randomized double-blind comparison of intramuscular 2 and 4 mg. butorphanol and 80 mg. meperidine was used. Pain intensity and pain relief were evaluated at half hour and hourly intervals for 4 hours. A 2 mg. dose of butorphanol was found to be analgesically equivalent to 80 mg. meperidine, while a 4 mg. dose of butorphanol was found to be more effective than 80 mg. meperidine and 2 mg. butorphanol. Each patient received up to 2 doses of analgesic medication when necessary. There was no significant difference in the incidence of side effects among treatments. One patient had visual hallucinations after a 2 mg. dose of butorphanol, possibly owing to its antagonistic activity to significant narcotic experience given previously at another hospital. There was no other evidence of toxicity with butorphanol. It was found to be a safe, effective and wall tolerated drug for the treatment of ureteral colic and is recommended in place of narcotics.
Weather and the incidence of urinary stone colic.
There were 204 patients in one specific district with renal colic who were studied to determine the relationship of the condition to climatic conditions. It was found that stones were prone to cause colic on warm days when air pressure was falling.
Clinical evaluation of blood lactate levels in equine colic.
Blood lactate levels were evaluated in 36 horses (43 cases) presented with colic. A correlation between increasing blood lactate levels and decreasing percentage survival has been shown. An appreciable anion gap was found in 7 of 10 cases analyzed in detail but in each case the entire gap could not be accounted for by lactate alone. Proposals are offered to account for the unmeasured anions. Blood lactate determination is suggested as a prognostic rather than a diagnostic aid for the equine practitioner and should be used to augment other clinical findings in the horse exhibiting colic.
Epidemiology of urinary stone colic.
Epidemiological study of urinary stone colics was done for 5 years in a defined basin located in the center of Japan. It was 2.5 times more frequent in males than in females. The difference was observed only in the age over 30 years. Recurrence occurred in 24.5% of the cases. Climatic factors were also analysed. The incidence was significantly high in summer and low in autumn. Days of decreasing air pressure and high temperature were frequently associated with stone colic.
Torsion of the uterus--a cause of colic in the mare.
A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.
Ureteral colic secondary to blood clot in hemophiliac.
Cryoprecipitate therapy replaces necessary clotting factors in a patient with factor VIII deficient hemophilia. In such a patient with hematuria, cryoprecipitate therapy can initiate the formation of a massive blood clot in the urinary collecting system. A case is reported of a factor VIII-deficient hemophiliac in whom ureteral colic and poor function of the right kidney developed because of a blood clot formed shortly after cryoprecipitate therapy.
Treatment of ureteral colic with intravenous indomethacin.
A randomized prospective double-blind study of the analgesic effect of 50 mg. intravenous indomethacin, a prostaglandin synthesis inhibitor, was done on 47 consecutive patients with acute ureteral colic. The placebo used was 5 mg. intravenous riboflavin because of the same color as indomethacin. Indomethacin provided complete relief in 78 per cent of the cases, while riboflavin provided relief in 30 per cent. The difference is statistically significant. No side effects were observed with indomethacin.
[Nephretic colic in patients with arrhythmia (author's transl)].
The authors relate one case of obstruction by emboly in the renal artery. The diagnosis were too late for conservative surgery. In this case, they insist on the particulary signs of that nephretic colic and they show the diagnosis measures which are able to permit a conservative surgery in urgency.
Biliary colic as a model for assessing analgesic activity in man.
Acute pain from biliary colic is a model of pathological pain suitable for pharmacological investigations. It has been found useful for assaying analgesic effect of a narcotic-type agent (pentazocine) and a non-narcotic drug (indoprofen), both given intravenously in a single dose. Differences in pain intensity scores assessed on a five-point scale were taken as measurement of the pain-relieving effect. Distribution-free methods were used to estimate the potency ratio of the tested drugs. The analgesic potency of indoprofen based both on total and peak effect was roughly one-tenth that of pentazocine on a weight-for-weight basis. No adverse reactions were associated with indoprofen and a few were found after pentazocine.
Renal autotransplantation for recurrent renal colic.
Renal autotransplantation as an alternative to ileal interposition has been done successfully in patients with repetitive episodes of renal colic. Urinary tract continuity has been re-established by anastomosis of a Boari tube directly to the renal pelvis. This has resulted in easy egress of recurrent calculi without pain. Furthermore, the musculature of the Boari tube seems to be adequate for prevention of vesicorenal reflux. The procedure has been devoid of electrolyte and mucous urinary retention problems associated with ileal interposition and it is advocated as an alternative in the management of such patients when medical therapy fails.
Indomethacin in the treatment of ureteral colic.
Based on a theoretical analysis of the genesis of ureteral colic, it was assumed that indomethacin, a potent prostaglandin synthesis inhibitor, ought to be useful in the treatment of patients with an obstructing ureteral stone. Experimental studies and clinical observations have verified this assumption.
[Verminous enteritis and thrombo-embolic colic in the horse. A description of 36 cases (author's transl)].
Based upon case reports from 36 cases of verminous thrombosis of arteria mesenterica cranialis--all of which were verified at necropsy--clinical symptoms, course and pathological lesions are described. Seventy five per cent of the patients were under 3 years old, and 73% of the cases showed initial signs during the period July-December. Salient clinical findings were, unthrifty appearance and emaciation, diarrhoea--observed in two thirds of the patients--and colic--observed in 50 per cent of the cases. Haematological and biochemical findings were inconclusive, yet, hypoproteinaemia was a rather frequent finding. At necropsy, enteritis and/or typhlocolitis were observed in 29 horses of which 8 horses had superficial lesions, 7 horses hyperplastic lesions and 12 horses diphteroid/necrotizing lesions. Fourteen per cent of the horses had renal infarctions. The findings are discussed in relation to recent observations on the epidemiology of Strongylus vulgaris infection and comparisons are drawn to findings in a material of horses with non-parasitic enteritis.
Colic in the horse. A clinical and clinical chemical study of 42 cases.
42 horses were examined. The physical signs with relation to circulatory insufficiency and the abdominal disease were registered following a two-phased examination procedure. Great prognostic value was found in the degree of circulatory insufficiency judged by pulse rate and character, filling of the jugular vein, skin temperature, colour of mucous membranes, capillary refill time, sweating, depression, skin turgor and degree of enophthalmus. In making a causal diagnosis the abdomen was examined for shape, tenderness, peristaltic sounds, gastric dilation by siphoning, abnormal rectal findings and macroscopic changes in peritoneal fluid. Greatest diagnostic difficulties were encountered in cases of intestinal atonia, acute enteritis and torsion of the colon. In selected (severe) cases laboratory tests were obtained. Blood samples were examined for packed cell volume, hemoglobin, red and white blood cell counts, differential white blood cell count, blood gases and acid-base status, lactate, serum total protein and albumin, plasma sodium, potassium, chloride, calcium, magnesium, inorganic phosphorus, glucose, creatinine, BUN, total bilirubin, ASAT, CK, BASP and GGT. Peritoneal fluid was examined for red blood and white cell counts, total protein, specific gravity, pH and lactate, and enzymes as in blood. Laboratory results generally confirmed the clinical signs of shock, and packed cell volume and blood lactate were regarded to be of greatest prognostic interest. Although the performed laboratory information, macroscopic evaluation was thought to reveal sufficient information in most cases. It was concluded that supervening shock is of decisive importance in severe forms of colic, and that a careful and repeated evaluation of the circulatory insufficiency often provides one with a tentative prognosis although the final diagnosis is not obtained. In spite of therapy fatal outcome was found in all seriously shocked horses.
Case report: equine colic associated with sand impaction of the large colon.
In most cases the outcome of impaction of the colon is favourable and with mild purging and lubrication, the mass can be broken down and the horse returned to normal health. It is important to reevaluate impaction cases which neither deteriorate or improve in a 24 hour period and to perform a paracentesis to evaluate the etiology and prognosis. A decision of euthanasia or surgical correction should be made as early as possible. Though initially stable, vital signs will deteriorate rapidly without warning. A critical evaluation of the client's farm management can prevent many impaction colics and the service practitioners provide is not complete unless the necessary changes are made.
[Alcoholism, colic diverticular disease and metabolic disorders (author's transl)].
70 patients with colic diverticular disease and 50 control subjects were compared. Sexes and ages were matched in the two groups. Significant higher frequencies of alcoholism (P < 0,00001), hyperlipidemia (P < 0,0001), impaired oral glucose tolerance test (P < 0,001), hyperuricemia (P < 0,01) and atherosclerosis (P < 0,000001) were noted in the diverticular group. Hypothesis about pathogenesis of diverticular disease are suggested.