Type 2 Myocardial Infarction Resulted from the Left Thoracic Stomach.

The universal definition of myocardial infarction (MI) provides five subtypes of acute myocardial infarction (AMI). We present an interesting case of a type 2 myocardial infarction caused by the dilation of the left thoracic stomach.

Type 2 myocardial infarction resulted from the left thoracic stomach

Abstract The universal definition of myocardial infarction (MI) provides five subtypes of acute myocardial infarction (AMI). We present an interesting case of a type 2 myocardial infarction caused by the dilation of the left thoracic stomach.

Autoimmune autonomic ganglionopathy associated with Sjögren's syndrome presenting with recurrent abdominal distension.

A 65-year-old woman with Sjögren's syndrome presented with recurrent abdominal distension, constipation, weight loss, orthostatic dizziness, loss of sweating and incomplete emptying of the bladder. Gastrointestinal dilatation but no evidence of malignancy or obstruction was found on CT of the abdomen, oesophagogastroduodenoscopy or colonoscopy. Postvoiding residual urine volume was increased. Antiganglionic acetylcholine receptor antibody was positive. We diagnosed as autoimmune autonomic ganglionopathy. The patient responded to corticosteroid treatment. One year after treatment, she continued to have mild gastrointestinal symptoms, but overall condition was stable without further intervention.

Micromotor-enabled active drug delivery for in vivo treatment of stomach infection.

Advances in bioinspired design principles and nanomaterials have led to tremendous progress in autonomously moving synthetic nano/micromotors with diverse functionalities in different environments. However, a significant gap remains in moving nano/micromotors from test tubes to living organisms for treating diseases with high efficacy. Here we present the first, to our knowledge, in vivo therapeutic micromotors application for active drug delivery to treat gastric bacterial infection in a mouse model using clarithromycin as a model antibiotic and Helicobacter pylori infection as a model disease. The propulsion of drug-loaded magnesium micromotors in gastric media enables effective antibiotic delivery, leading to significant bacteria burden reduction in the mouse stomach compared with passive drug carriers, with no apparent toxicity. Moreover, while the drug-loaded micromotors reach similar therapeutic efficacy as the positive control of free drug plus proton pump inhibitor, the micromotors can function without proton pump inhibitors because of their built-in proton depletion function associated with their locomotion.Nano- and micromotors have been demonstrated in vitro for a range of applications. Here the authors demonstrate the in-vivo therapeutic use of micromotors to treat H. pylori infection.

Hinchazón/distensión funcional: un enfoque práctico / Functional abdominal bloating/ distension: a practical approach

Although abdominal bloating and distension are frequent symptoms, they are considered a challenge in medical practice. Treatment alternatives with varying efficacy levels, associated to the lack of knowledge about this problem, generate difficulties in the doctor­patient relation, and patient's frustration and anxiety. Advances in understanding their etiopathogenetic factors have lead treatment of these patients towards a personalized approach. The purpose of the article is to provide a brief description about abdominal bloating and distension, and ultimately give a practical approach of this condition.

A pesar de que la hinchazón (bloating) y la distensión abdominal son síntomas altamente frecuentes, son considerados un desafío en el quehacer médico. Alternativas terapéuticas con grados de eficacia variables, asociado a un desconocimiento en el enfrentamiento clínico, generan dificultades en la atención de estos pacientes por parte de los médicos, además de frustración para el paciente. Avances en la comprensión de su etiopatogenia han permitido dirigir el tratamiento de estos pacientes de manera personalizada. Este artículo tiene como objetivo realizar una breve descripción del cuadro, y dar finalmente un enfoque práctico frente a esta condición.

A review of the gastroprotective effects of ginger (Zingiber officinale Roscoe).

The rhizomes of Zingiber officinale Roscoe (Zingiberaceae), commonly known as ginger is an important kitchen spice and also possess a myriad health benefits. The rhizomes have been used since antiquity in the various traditional systems of medicine to treat arthritis, rheumatism, sprains, muscular aches, pains, sore throats, cramps, hypertension, dementia, fever, infectious diseases, catarrh, nervous diseases, gingivitis, toothache, asthma, stroke and diabetes. Ginger is also used as home remedy and is of immense value in treating various gastric ailments like constipation, dyspepsia, belching, bloating, gastritis, epigastric discomfort, gastric ulcerations, indigestion, nausea and vomiting and scientific studies have validated the ethnomedicinal uses. Ginger is also shown to be effective in preventing gastric ulcers induced by nonsteroidal anti-inflammatory drugs [NSAIDs like indomethacin, aspirin], reserpine, ethanol, stress (hypothermic and swimming), acetic acid and Helicobacter pylori-induced gastric ulcerations in laboratory animals. Various preclinical and clinical studies have also shown ginger to possess anti-emetic effects against different emetogenic stimuli. However, conflicting reports especially in the prevention of chemotherapy-induced nausea and vomiting and motion sickness prevent us from drawing any firm conclusion on its effectiveness as a broad spectrum anti-emetic. Ginger has been shown to possess free radical scavenging, antioxidant; inhibition of lipid peroxidation and that these properties might have contributed to the observed gastroprotective effects. This review summarizes the various gastroprotective effects of ginger and also emphasizes on aspects that warranty future research to establish its activity and utility as a gastroprotective agent in humans.

Silent acute gastric dilatation due to Salmonella infection in a diabetic elderly.

Acute gastric dilatation is a potentially life-threatening entity that has been reported in patients with some acute infections like pneumonia and staphylococcal bacteremia. We describe a case of acute gastric dilatation presenting atypically in a 65-year-old diabetic with Salmonella diarrhoea. By the fourth day of hospital admission the patient's abdomen was distended in the absence of pain, nausea or vomiting. An abdominal radiograph showed marked gastric dilatation with no evidence of obstruction or ileus. With nasogastric tube insertion and initiation of intravenous antibiotics, the stomach was back to normal size. It is likely that Salmonella infection was the major cause of acute gastric dilatation in this patient.

[Effects and mechanisms of Herba dendrobii on rats with stomach-heat syndrome].

OBJECTIVE: To observe the effects of Herba dendrobii on rats with stomach-heat syndrome and to explore the mechanisms. METHOD: Rats were fed with decoction of Rhizoma Zingiberis for 15 continuous days to induce the model of stomach-heat syndrome. After modeling, Herba Dendrobii (HD) decoction were given (in the doses of 1.5, 0.75 g x kg(-1) respectively) for 10 days. After treatment, amount of the daily diet, volume and absorbance of urine, pellet number and moistness of excrement, color and coating degree of tongue were recorded; the body thermal effects were detected with thermal texture maps (TTM) system; the biochemical indexes of blood reflecting the physiological function of stomach, including thromboxaneB2 (TXB2), 6-keto-prostaglandin F1alpha(6-keto-PGF1alpha), motilin (MTL), gastrin (Gas), somatostation (SS), interleukin-4 (IL-4) and interleukin-8 (IL-8) were measured by radio immunoassay; and the histological changes of gastric mucosa were observed by hematoxylin-eosin (HE) stain. RESULT: The model rat had yellow coating and red tongues (P < 0.05). The amount of daily diet were increased (over 10%), urine volume and excrement pellet number were decreased (over 10%). The their urine color became deep (P < 0.01) and their excrement became dry. The temperatures in head, neck, left fore-armpit, chest, up-abdomen, mid-abdomen of the model rats were raised up (difference > 0.5 degrees C or difference > 1.0 degree C ). The content of 6-keto-PGF1alpha in blood of model rats decreased evidently (P < 0.01), and the contents of MTL, Gas and IL-8 increased conspicuously (P < 0.01). The histological changes of gastric mucosa in the model rats were as follows: diffuse congestion, infiltration of neutrophil, less secretion, decrease of the number of chief and parietal cells, etc (P < 0. 05 or P < 0.01). After treatment with HD, except the daily food weight, the temperatures in head, neck and chest, the content of MTL and the number of chief cells, the other indexes observed above were improved noticeably (difference > 0.5 RC or difference > 1.0 degree C, P < 0.05 or P < 0.01). CONCLUSION: The reason why HD relieves the general symptom and sign the gastric mucosa of rats with stomach-heat syndrome is that HD can increase 6-keto-PGF1alpha and decrease IL-8, Gas, TXB2 in their blood.

[Comparative clinical efficacy of a probiotic vs. an antibiotic in the treatment of patients with intestinal bacterial overgrowth and chronic abdominal functional distension: a pilot study]. / Eficacia comparativa de un probiótico vs un antibiótico en la respuesta clínica de pacientes con sobrecrecimiento bacteriano del intestino y distensión abdominal crónica funcional: un estudio piloto.

INTRODUCTION: Patients with intestinal bacterial overgrowth (SIBO) are usually treated with different antibiotics. Certain probiotics have proved to be clinically effective in patients with abdominal distension. OBJECTIVE: To compare the short-term clinical efficacy of metronidazol vs. a probiotic in patients with SIBO and functional chronic abdominal distension. Patients and methods. This was a randomized prospective pilot study. The study population consisted of 50 patients with chronic abdominal distension (Rome III criteria) and diagnosis of SIBO made by a lactulose H2 breath test. Patients were consecutively randomized to receive either metronidazol or a probiotic. The metronidazol group consisted of 25 subjects (23 women, median age 49 +/- 19 years old), who received metronidazol (Flagyl), 500 mg bid for 5 days. The probiotic group consisted of 25 subjects (20 women, median age 58 +/- 19 years old). The probiotic administered to the latter group contained Lactobacillus casei (3.3 x 10(7) UFC), Lactobacillus plantarum (3.3 x 10(7) UFC), Streptococcus faecalis (3.3 x 10(7) UFC) and Bifidobacterium brevis (1.0 x 10(6) UFC) (Bioflora) and 5 ml bid were administered for 5 days. Both groups went on the same diet, which consisted in reduced consumption of alcohol, legumes, dairy products and leafy green vegetables. Response to treatment was assessed by an independent questioner 15 days post treatment. A five-level overall response questionnaire was used. Responses included much better, better, the same, worse, and much worse. Better and much better were considered positive responses. RESULTS: Thirteen (52%) subjects receiving metronidazol and 20 (82%) receiving the probiotic referred clinical improvement after the treatment. A statistically significant difference favoured the use of the probiotic (P = 0.036). All the study patients completed treatment. No adverse events leading to treatment discontinuation were observed. CONCLUSIONS: Based on this pilot study results, we can suggest that the probiotic herein used has a higher efficacy than metronidazol in the early clinical response of patients with chronic abdominal distension and SIBO.

Evaluation of lidocaine treatment and risk factors for death associated with gastric dilatation and volvulus in dogs: 112 cases (1997-2005).

OBJECTIVE: To determine clinical features, outcome, risk factors for death, and efficacy of IV administration of lidocaine as a prophylactic treatment for ischemic reperfusion injury in gastric dilatation and volvulus (GDV) in dogs. DESIGN: Retrospective case series. ANIMALS: 112 dogs with GDV. PROCEDURES: Data pertaining to breed; time lag to admission; clinical, clinicopathologic, and surgical findings; lidocaine treatment; and postoperative complications were assessed for association with outcome. RESULTS: German Shepherd Dogs (28.6%) and Great Danes (17%) were significantly over-represented. Risk factors for death included time lag (> or = 5 hours vs < 5 hours) from onset of clinical signs to admission (46.0% vs 11.3%), rectal temperature (< or = 38 degrees C vs > 38 degrees C [< 100.4 degrees F vs > 100.4 degrees F]) at admission (40.0% vs 14.9%), presence or absence of ARF (67.0% vs 23.3%), presence or absence of suspected gastric wall necrosis (59.3% vs 16.0%), and untreated gastric wall necrosis, compared with treated gastric wall necrosis (100% vs 47.6%). Overall mortality rate was 26.8%; no significant differences were detected in mortality rate or postoperative complications between dogs that received lidocaine IV prior to surgical intervention (52.0%) and dogs that did not (48.0%). Mean +/- SD hospitalization time was longer in the lidocaine treatment group (3.5 +/- 1.9 days vs 2.5 +/- 1.4 days). CONCLUSIONS AND CLINICAL RELEVANCE: Presence of the identified risk factors should warrant aggressive treatment. Lidocaine treatment was not associated with mortality rate or postoperative complications, but was associated with prolonged hospitalization time.

Abdominal distension in collapsed diarrhoeic calves: biochemical findings and treatment.

Thirty-seven of 53 diarrhoeic calves hospitalised for intravenous fluid therapy were classified as very severely acidotic (total carbon dioxide less than 8 mmol/litre) by using a Harleco apparatus. All the calves were given intravenously 10 to 20 litres of electrolyte solution which contained 144 mmol/litre sodium, 4 mmol/litre potassium, 113 mmol/litre chloride and 35 mmol/litre bicarbonate, and in addition the 37 very severely acidotic calves received 400 ml of 1M sodium bicarbonate in the first 5 litres of fluid administered. Sixteen of the 37 very severely acidotic calves had a distended right flank, suggesting the presence of a dilated fluid-filled viscus. Neither their history nor other clinical signs were useful predictors of the distension. The distended calves had significantly higher plasma concentrations of sodium and chloride, and significantly lower plasma creatinine concentrations than the calves which were not distended. Treatment was successful in all the 21 non-distended calves but four of the distended calves died despite treatment. The resolution of the distension in the successfully treated calves, coincided with a significant increase in plasma bicarbonate concentration and the passage of large amounts of malodorous mucoid faeces.

Effects of flunixin meglumine on dogs with experimental gastric dilatation-volvulus.

Gastric dilatation-volvulus (GDV) was created experimentally and maintained for 90 minutes in 16 anesthetized, mixed-breed dogs. After the GDV was corrected, normal saline solution (0.044 mL/kg intravenously [IV]) was administered to eight dogs (controls), and flunixin meglumine (2.2 mg/kg IV) was administered to eight dogs. Microspheres labeled with radioactive cobalt, scandium, tin, or niobium were injected intravenously at baseline (before GDV) and minutes 90, 100, and 270, respectively, to determine tissue blood flows. Plasma endotoxin and prostacyclin were measured at the same intervals. Electrocardiogram, mean arterial pressure, portal pressure, and cardiac output were recorded continuously. Dogs were euthanatized at minute 270 and necropsied. There was no significant difference between treatment groups for any measured variable at any time. Endotoxin levels increased significantly during GDV. Prostacyclin levels were lower in dogs treated with flunixin meglumine than in controls at minutes 210 and 270. Histopathologic findings were similar for all dogs and consistent with those associated with endotoxemia. Flunixin meglumine treatment did not alter cardiac indices or tissue blood flows significantly. However, elevation of prostacyclin was inhibited by flunixin meglumine, which suggested that continued effects of endotoxic damage might be attenuated or inhibited.

Medical treatment of right-sided dilatation of the abomasum in cows.

Twenty-two cows with right-sided displacement of the abomasum were treated with hyoscine-n-butyl bromide and dipyrone (Buscopan compositum; Boehringer Ingelheim). Within 24 hours 11 had recovered completely, three had improved, six had shown no improvement and two had been slaughtered. Within 48 hours 17 of the cows had recovered completely and five had been slaughtered.