ABSTRACT
The authors present a case of a 40-year-old female patient examined repeatedly in the course of 11 years and hospitalized on account of pain in the hypogastrium, subfebrile temperatures, watery diarrhoea, hypokaliaemic alkalosis, weakness, fatigue and loss of body weight. As to laboratory examinations hypokaliaemia, hyponatraemia, metabolic alkalosis, irregularly elevated CRP values and minor leucocytosis predominated. A weight loss of cca 8 kg along with a severe mineral deficiency and clinical symptomatology called for parenteral nutrition with a mean daily substitution of 240 mmol K and 200 mmol Na. Due to the clinical condition and non-specific results of graphic and histological examinations the possibility of a VIPoma was considered. This diagnosis was confirmed by laboratory examinations and clinically--after the onset of corticoid treatment marked improvement of the general condition occurred. Finally the authors discuss diagnostic and in particular therapeutic possibilities in this disease.
Subject(s)
Hypokalemia/etiology , Pancreatic Neoplasms/complications , Vipoma/complications , Adult , Female , Humans , Pancreatic Neoplasms/diagnosis , Vipoma/diagnosisABSTRACT
The authors describe their own methodical procedure used for estimation of energy requirements of patients with a defined nutrition. They ascribe importance to the quantitative assessment of the degree of catabolism of endogenous proteins the value of which they transform mathematically to calculate the catabolic factor with which they multiply the basal energy output calculated according to Harris-Benedict equations. At the same time they take into account also the thermogenic action of nutrients. In 28 patients with gastroenterological diseases they confronted their own procedure with indirect calorimetry and theoretical calculations using Jabor's catabolic factor and Nejedly's formula. Differences between values of their own and other theoretical calculations, as compared with the results of indirect calorimetry, nor the results of Jabor's and Nejedly's calculation as compared with those of the authors did not reach the level of statistical significance. With regard to the assembled results the authors consider the suggested procedure for estimation of energy requirements as feasible, in particular when indirect calorimetry is not available.
Subject(s)
Energy Metabolism , Proteins/metabolism , Calorimetry, Indirect , Female , Humans , Male , Middle Aged , Nutrition Disorders/diagnosis , Nutrition Disorders/metabolism , Nutrition Disorders/therapyABSTRACT
Rational antithrombotic treatment in vascular occlusions is a marked advance in the therapeutic results, incl. reduced mortality. The prerequisite of success is early adequate thrombolytic or anticoagulant treatment taking into account absolute and relative contraindications. Despite this it is necessary to foresee the risk of haemorrhagic complications and orientate diagnosis with the aspect in mind. As an example three case-histories are presented, their common sign being haemorrhage into the lower extremities during antithrombotic treatment. Attention is drawn to the difficulty of differential diagnosis of venous thrombosis and haemorrhage into muscles or intermuscular spaces where at a given site computer tomography is a great asset. In the treatment in addition to surgical intervention in particular hyperbaric oxygen therapy proves useful.
Subject(s)
Thrombophlebitis/diagnosis , Aged , Anticoagulants/adverse effects , Diagnosis, Differential , Female , Hemorrhage/chemically induced , Hemorrhage/diagnosis , Humans , Leg/blood supply , Male , Middle Aged , Thrombophlebitis/drug therapyABSTRACT
The authors tested in an open clinical investigation in a group of 30 patients the therapeutic effectiveness and tolerance of the newly developed preparation Ranitidine VUFB in the treatment of peptic gastroduodenal ulcers. The preparation was administered to patients with an endoscopically confirmed diagnosis, 300 mg/day by the oral route, for a period of 4 weeks. A positive and rapid effect on regression of subjective complaints was observed and a very favourable effect on healing of the ulcer. After four weeks complete healing of gastroduodenal ulcers was recorded in 73% of the patients, in another 10% marked diminution of the ulcer occurred with a tendency to heal. The preparation was tolerated very well by the patients and there were no serious side-effects. The assembled results are comparable with data on similar preparations prepared abroad and Ranitidine VUFB should be included among desirable and useful anti-ulcer drugs.
