Subject(s)
Bacterial Infections/transmission , Endoscopes/microbiology , Endoscopes/virology , Endoscopy, Gastrointestinal/adverse effects , Technology Assessment, Biomedical , Virus Diseases/transmission , Bacterial Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Disinfection/methods , Endoscopes/adverse effects , Endoscopy, Gastrointestinal/methods , Equipment Contamination/prevention & control , Evaluation Studies as Topic , Humans , Risk Assessment , United States , Virus Diseases/prevention & controlSubject(s)
Endoscopes , Endoscopy, Gastrointestinal/methods , Hemostatic Techniques/instrumentation , Endoscopes/adverse effects , Endoscopy, Gastrointestinal/adverse effects , Equipment Design , Equipment Safety , Health Care Costs , Hemostatic Techniques/economics , Humans , Sensitivity and Specificity , Technology Assessment, Biomedical , United StatesSubject(s)
Anesthetics, Intravenous/administration & dosage , Endoscopy, Gastrointestinal/methods , Premedication/standards , Propofol/administration & dosage , Technology Assessment, Biomedical , Anesthetics, Intravenous/adverse effects , Anesthetics, Intravenous/economics , Female , Humans , Male , Pain Measurement , Patient Satisfaction , Propofol/adverse effects , Propofol/economics , Randomized Controlled Trials as Topic , Sensitivity and SpecificityABSTRACT
Although chlorpropamide and tolbutamide are well recognized as causes of hepatotoxicity, there are only 3 reported cases of hepatic injury caused by a third oral hypoglycemic agent, tolazamide. In 2 of these cases, the liver-function tests returned to normal when the drug was discontinued. In the third case, the patient had cholestasis from chlorpropamide before administration of tolazamide and developed chronic liver disease. We are reporting the second instance of chronic liver disease induced by tolazamide. Our patient had been taking chlorpropamide, but she had no evidence of liver disease before administration of tolazamide. Tolazamide should be considered as a drug capable of producing hepatotoxicity that on occasion may be chronic.
Subject(s)
Chemical and Drug Induced Liver Injury , Tolazamide/adverse effects , Aged , Chlorpropamide/therapeutic use , Diabetes Mellitus/drug therapy , Female , Humans , Jaundice/chemically induced , Tolazamide/therapeutic useABSTRACT
In 2 cases of ampullary tumor, the diagnosis was made by intraampullary biopsy after an abnormality was discovered via the fluoroscope during endoscopic retrograde cholangiopancreatography. One case was a villotubular adenoma with dysplasia and carcinoma in situ, and the other, a polypoid adenocarcinoma of the ampulla of Vater. These tumors were not visualized on upper gastrointestinal barium studies and conventional duodenoscopy nor by direct vision during endoscopic retrograde cholangiopancreatography. In the past the diagnosis of ampullary neoplasm has been most often made of surgery and on autopsy. Only in 11 of 538 patients reviewed was the diagnosis made by biopsy of a tumor visible at endoscopy. As demonstrated by the two cases we report, intraampullary biopsy of lesions visualized on fluoroscopy during endoscopic retrograde cholangiopancreatography may facilitate early diagnosis.
