ABSTRACT
BACKGROUND: Retrospective studies of duodenal polyps have shown a prevalence of 0.3%-1.5% in patients referred to upper endoscopy, and histopathologic classifications have been inconsistent. METHODS: A prospective consecutive study was carried out in 584 patients referred to diagnostic upper endoscopy. Symptoms were registered on a questionnaire, endoscopic and histopathologic findings on standard forms. The same pathologist evaluated all biopsy specimens. RESULTS: Twenty-seven patients had polyps in the first and/or second part of the duodenum, for a prevalence 4.6%. Sixteen polyps were either inflammatory (nine polyps) or ectopic gastric mucosa (seven polyps). Both of these polyp types were practically always non-solitary, sessile, small, and located in the duodenal bulb. Seven polyps were covered by normal mucosa, three being endoscopically typical lipomas. Two polyps were adenomas (0.4% of all the patients and 7% of the polyps), and both were found in the descending part. One hyperplastic polyp of the gastric type and one case of fibrosis were found. CONCLUSIONS: 1) Duodenal polyps are found in 4.6% of patients referred to upper endoscopy and should therefore be looked for. 2) Multiple, small polyps in the duodenal bulb are always benign and need neither biopsy nor treatment (in patients with familial polyposis biopsy is recommended). 3) In the descending duodenum polyps are rare, but a substantial number of them are adenomas. Biopsy is therefore mandatory in this localization.
Subject(s)
Duodenal Neoplasms/epidemiology , Duodenal Neoplasms/pathology , Intestinal Polyps/epidemiology , Intestinal Polyps/pathology , Adenoma/pathology , Endoscopy, Gastrointestinal , Female , Humans , Male , Middle Aged , Prevalence , Prospective StudiesABSTRACT
Rectosigmoid pressure recordings by means of open-ended perfused catheters were performed on 21 patients with the irritable bowel syndrome (IBS). Motility indexes were calculated in resting conditions, after sham feeding, after a meal, and after 0.5 mg neostigmine intravenously. Each step of stimulation caused a significantly increased motility index compared with the previous step (p less than 0.01). The increase in rectosigmoid pressure activity after sham feeding indicates the existence of a cephalic phase in the postprandial motor response of the colon in IBS.
Subject(s)
Colon, Sigmoid/physiopathology , Colonic Diseases, Functional/physiopathology , Food , Gastrointestinal Motility , Neostigmine/administration & dosage , Rectum/physiopathology , Adult , Aged , Female , Gastrointestinal Motility/drug effects , Humans , Injections, Intravenous , Male , Middle AgedABSTRACT
Forty-four fractures of the scaphoid bone were treated with a short-term removable orthoplast cast and compared with 48 fractures treated with a conventional long-arm plaster cast. At the follow-up, there was no difference between the two treatment groups as regards nonunion or other sequelae. We conclude that the inconvenience of the treatment of scaphoid fracture and the need of physiotherapy can be reduced by using an orthoplast cast.
Subject(s)
Carpal Bones/injuries , Casts, Surgical , Fracture Fixation , Fractures, Bone/therapy , Humans , Polymers , TerpenesABSTRACT
We report 2 cases of ureteral endometriosis in which initial hormonal management, including danazol, failed to reverse or to stop the progressing ureteral stenosis. After reviewing the various methods of treatment presented in the literature we conclude that solid documentation of the effect of danazol against ureteral endometriosis is lacking. To preserve kidney function we recommend resection of the affected portion of the ureter.
Subject(s)
Danazol/therapeutic use , Endometriosis/drug therapy , Pregnadienes/therapeutic use , Ureteral Neoplasms/drug therapy , Adult , Endometriosis/complications , Endometriosis/surgery , Female , Humans , Ureteral Neoplasms/complications , Ureteral Neoplasms/surgery , Ureteral Obstruction/etiologyABSTRACT
The concentration of magnesium in muscle was determined and a standardized magnesium load test was performed in 21 patients, who 4 to 10 years previously had undergone intestinal bypass operations for severe obesity. The plasma concentration and 24-h urinary excretion of magnesium were also studied. Basic urinary excretion of magnesium and muscle magnesium were significantly lower in patients compared to healthy controls, while no differences were found in plasma magnesium. A slight negative correlation between muscle magnesium and retained magnesium was demonstrated (r = -0.51, P less than 0.05). Patients with magnesium retention greater than 20 per cent showed a significant decrease of magnesium retention after treatment with magnesium chloride mixture. Four patients with primarily low muscle magnesium all demonstrated an increment in the amount of magnesium in muscle after treatment. The load test described can be applied as a screening test in diagnosing magnesium deficiency.
