Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Jan 1985
Bleeding pattern before admission as guideline for emergency endoscopy.
In a prospective study of 539 patients admitted because of hematemesis and melena the bleeding pattern before admission was compared with the findings obtained on emergency endoscopy and the subsequent clinical course. Ranked in order of prognostic importance, red hematemesis with melena, black hematemesis with melena, and red hematemesis alone increased the probability of massive hemorrhage. Moreover, black hematemesis with melena was the superior predictor of bleeding ulcer, the commonest lesion carrying the risk of massive hemorrhage. ⋯ The order of prognostic importance was supported by the transfusion requirement. In screening for a potentially life-threatening ulcer hemorrhage, emergency endoscopy is recommended in patients with black hematemesis with melena or with red hematemesis with or without melena. In patients presenting with black hematemesis or melena alone endoscopy may be postponed to the next convenient daytime.
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Subjects with upper abdominal pain without any demonstrable organic basis are often met with the attitude that the pain is "not real'. Twenty-five patients with long-standing upper abdominal pain but with normal findings on X-ray examination, gastroduodenoscopy, and relevant blood analyses were examined with pain-measuring techniques. ⋯ A methodological study of the submaximal effort tourniquet technique was performed on the healthy volunteers. The method was found to be suitable for use in pain studies, since the pain produced gradually increased as a linear function of time.
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Scand. J. Gastroenterol. · Jan 1983
Early detection of acute fulminant pancreatitis by contrast-enhanced computed tomography.
Twenty-eight consecutive patients with a first attack of acute alcohol-induced pancreatitis were examined by computed tomography (CT). After a survey scan of the abdomen a rapid contrast bolus (400 mg I/kg) was given intravenously, and the contrast enhancement of the pancreatic parenchyma was measured from a consecutive series of pancreatic scans. ⋯ Patients recovering by conservative treatment showed normal or increased enhancement. The contrast enhancement seems to constitute a useful criterion for the early differentiation of acute fulminant pancreatitis from less severe forms of the disease.
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Scand. J. Gastroenterol. · Jan 1983
Comparative StudyInhibition of cysteamine-induced duodenal ulcer in the rat by bile diversion. Enhancement of the ulcerogenic effect of cysteamine by taurocholic and glycocholic acids.
Three groups of rats were twice given cysteamine subcutaneously in a dose of 20 mg/100 g body weight. Nine of 10 controls developed severe duodenal ulcers. ⋯ However, rats submitted to the same operation but drinking a solution with 5 mmol/l sodium salts of taurocholic and glycocholic acid, 1:3, developed severe duodenal ulcers after cysteamine injections (8 of 10). The conclusion is that neither the chemical cysteamine nor hydrochloric acid alone can be made responsible for cysteamine-induced duodenal ulcer in the rat, but that bile salts clearly enhance the ulcerogenic property of cysteamine.
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Scand. J. Gastroenterol. · Jan 1981
Long-term parenteral nutrition. II. Catheter-related complications.
Catheter-related complications were investigated in 70 patients receiving long-term parenteral nutrition (LTPN) for 1 to 63 months (median, 4.5 months) with a total observation period of 816 patient-months. Two hundred and three central venous catheters were used: 52 Broviac silicone rubber catheters and 151 Intracaths or Argyle baby feeding tubes made from polyvinyl chloride with plasticizers. The median duration was longer for Broviac catheters (5.0 months) than for the other catheters (1.1 months). ⋯ Catheter sepsis should be treated with both catheter exchange and antibiotics. Because of the high incidence of thrombosis we recommend that all patients on LTPN receive anticoagulant therapy. However, the value of anticoagulant therapy is not proved in a prospective, controlled study.