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  • 1
    Electronic Resource
    Electronic Resource
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 41 (1998), S. 1406-1410 
    ISSN: 1530-0358
    Keywords: Anal fissure ; Isosorbide dinitrate ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Anal fissure is a tear of the anoderm, which eventually can become an ulcer. Chronic anal fissure is perpetuated by contraction of the internal sphincter, believed to reduce perfusion. Nitric oxide is a neurotransmitter mediating vasodilation and internal anal sphincter relaxation. The aim of the present study was to evaluate both the effect and the effective dose regimen of isosorbide dinitrate, a nitric oxide donor, as a treatment for chronic anal fissure. METHODS: Isosorbide dinitrate, Isoket® spray (Schwarz-Pharma, Mannheim, Germany), was used to treat 41 patients with chronic anal fissure. Anal manometry was performed in all patients before they entered the study. The treatment program consisted of digital application of isosorbide dinitrate in a dose of 1.25 mg or 2.5 mg three times each day for four weeks. At the end of the trial, patients were followed up for an average time of 11 ± 1 months. RESULTS: In 34 (83 percent) patients, the fissure healed within one month of treatment (mean, 3 ± 0.1 weeks). The average time for symptoms to disappear was 6.5 ± 0.7 days. In six (14.6 percent) patients the anal fissure did not heal even after four weeks of further treatment, and they underwent lateral sphincterotomy. Six patients relapsed during the follow-up period, but responded to another course of treatment. A dose of 2.5 mg of isosorbide dinitrate caused a greater reduction in maximum anal resting pressure than a dose of 1.25 mg. CONCLUSIONS: Topical isosorbide dinitrate is an effective and safe treatment for chronic anal fissure. In our experience the optimal dose regimen is 2.5 mg three times each day.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 36 (1991), S. 1255-1258 
    ISSN: 1573-2568
    Keywords: chronic nausea ; vomiting ; motility ; gastric emptying time
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nausea and vomiting are symptoms sometimes associated with motor dysfunction. We compared a group of young patients suffering from chronic nausea and/or vomiting and normal upper gastrointestinal x-ray series with a control group. The members of both groups underwent isotopic examinations of their stomachs. The aim of the study was to find a simple method of checking the stomach and proving a motor dysfunction in a group of patients with chronic, inexplicable nausea and vomiting. Patients and controls fasted for an least 6 hr were given 0.5 mCI of [99mTc] diethylene triaminopentaacetic acid orally in 150 cc milk with 50 g cornflakes. A time-activity curve was obtained and radioactivity over the stomach was recorded exponentially. The parameter of theT1/2 emptying time was used. In normal controlsT1/2 emptying time ranged from 18 to 26 min. Twenty-five symptomatic patients were examined, three of whom achieved normal values, but 22 patients showed pathologic results ranging from 36 to 184 min. In patients with chronic nausea and/or vomiting an isotopic examination of the stomach may provide a simple and rapid diagnostic method of evaluation.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-2568
    Keywords: prostaglandins ; duodenal ulcer ; arbacet
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy of arbacet (a synthetic analog of prostaglandin E2) in definite cytoprotective but minimal antisecretory dose was evaluated in the treatment of duodenal ulcer. One hundred five patients with endoscopically proven duodenal ulcer were randomized in a double-blind manner to receive four times daily either arbacet 25 μg or placebo. Ulcer healing was assessed endoscopically after two and four weeks of treatment. The mean age, sex distribution, and tobacco and alcohol consumption were similar in the two treatment groups. The ulcers of 16 patients in both the placebo and the arbacet-treated group healed after 14 days of treatment. At the end of the study, healing of the ulcer was observed in 69.2% of the arbacet-treated patients and in 60.4% of patients in the placebo treated group. (Difference was not statistically significant). We conclude that cytoprotective doses of arbacet with minimal antisecretory properties are not effective in duodenal ulcer healing.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-2568
    Keywords: substance P ; ulcerative colitis ; constipation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Substance P content was determined by radioimmunoassay in colonic mucosa from 24 patients with chronic severe constipation, 16 with active ulcerative colitis, and 28 normal controls. In patients with chronic severe constipation, the mean concentration of substance P (19.9±8.2 pg/mg) was significantly lower than in normal subjects (71±18 pg/mg). In patients with ulcerative colitis, colonic substance P concentration in inflamed mucosa (170±46 pg/mg) was significantly higher than its levels in normal subjects. Substance P may therefore have a role in the pathogenesis of clinical conditions associated with diarrhea and constipation.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-2568
    Keywords: ANEMIA ; PORTAL HYPERTENSION
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This retrospective cohort study was aimed atinvestigating the effects of anemia on the hemodynamicdisturbances associated with portal hypertension. Inall, 202 consecutive nontreated portal-hypertensive patients referred for evaluation to our HepaticHemodynamic Laboratory were included. Compared to thenonanemic patients, anemic cirrhotic patients had anincreased cardiac output (7.9 ± 1.9 vs 7.1± 2 liters/min, P 〈 0.01), and a decreased mean arterialblood pressure (82 ± 11 vs 94 ± 13 mm Hg,P 〈 0.0001) and systemic vascular resistance (838± 235 vs 1102 ± 356dyn/sec/cm5, P 〈 0.0001). Similar resultswere obtained when Child A or Child B-C patients were analyzedseparately. Multivariate logistic regression disclosedthat hemoglobin concentration, in addition to age, sexazygos blood flow, and albumin concentration, was anindependent factor influencing the degree of systemicvasodilation in cirrhotic portal-hypertensive patients.This study discloses that anemia worsens thehyperdynamic circulation associated with portalhypertension. Since hemoglobin concentration may change withtime, this parameter should be taken into account whenevaluating hemodynamics in portal-hypertensivepatients.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 28 (1983), S. 807-811 
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To establish whether the cytoprotective properties of prostanoids can be used for maintaining remission in ulcerative colitis, 24 patients with ulcerative colitis in remission were randomly assigned to receive either 15(R), 15-methyl-PGE2 (200 μg/day) or to continue with sulfasalazine (2.0 g/day) for up to 28 weeks. All patients included were symptom free and sigmoidoscopy and rectal biopsy performed upon entering the trial did not reveal any signs of disease activity. Of the 12 patients who discontinued sulfasalazine and were allocated to receive 15(R), 15-methyl-PGE2, five flared up within the first four weeks and three others had to stop the trial because of severe diarrhea. Because of the high incidence of side effects and flare-up, the other four patients were instructed to stop the trial. In contrast, only two of the 12 sulfasalazine-treated patients flared-up and the other 10 concluded the 28 weeks of the trial symptom free. These results indicate that 15(R), 15-methyl-PGE2 cannot be used to control and support remission in ulcerative colitis patients.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1437-9813
    Keywords: Bile duct abnormalities ; Bile duct diseases ; Caroli's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Congenital cystic dilatation of the intrahepatic biliary ducts has been infrequently recognized in childhood. The majority of cases present with dilatation of both the intrahepatic and extrahepatic biliary systems. This report describes a 7-year old boy presenting with hepatomegaly and fever. Computed tomography, ultrasonography, ERCP, and hepatic scintigraphy demonstrated bilobar intrahepatic cystic dilatation of the biliary tract with a normal extrahepatic system. The symptoms were immediately alleviated by a short course of antibiotics. Nevertheless, the patient is at risk for recurrent infection, malignancy, and hepatic failure and is awaiting an appropriate operative solution for his extremely rare anomaly.
    Type of Medium: Electronic Resource
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