Anthranoid self-medication causing rapid development of melanosis coli. (57/342)

It is widely known that long-term use of anthranoid-containing laxatives is the cause of melanosis coli. We describe a case of melanosis coli, which occurred in a 39-year-old liver transplant patient who took an over-the-counter product containing aloe, rheum and frangula. The typical brownish pigmentation of the colonic mucosa developed in a period of ten months. The anthranoid medication was stopped and follow-up colonoscopy one year later showed normal looking mucosa once more. However, in contrast to previous examinations, a sessile polypoid lesion was found in the transverse colon. Histology showed tubulovillous adenoma with extensive low-grade dysplasia. Since there have been preliminary reports suggesting a possible role of anthranoid-containing laxatives in the development of colorectal adenomas and cancer, their use should be discouraged.  (+info)

Stability of radiothyroxine plasma disappearance curve despite catharsis and unblocked thyroidal uptake of radioiodide. (58/342)

Plasma radioactivity was measured over 21 days after an intravenous injection of 50 muCi of 125I-T4 in eight normal men. No thyroid-blocking medication was given. Four subjects (castor oil group) received 30 ml of castor oil on each of Days 13, 14, and 15, while the other four subjects (control group) were studied without medication. After A 5-day equilibration period, plasma 125I-T4 was measured on Days 5-13 in order to calculate the disappearance curve for each subject and to derive the mean for each experimental group. The curves were then extrapolated to Day 21. Measured radioactivity did not depart significantly from the extrapolated line, either during the castor oil period (Days 14, 15, and 16) or during the recovery period (Days 17, 19, and 21). The castor oil, therefore, had no observable effect on the clearance of plasma radioactivity. None of the subjects had a late increase in plasma radioactivity to suggest recirculation of radioiodide or buildup of iodoproteins. In normal subjects, radiothyroxine plasma levels up to 21 days are not significantly affected by short-term catharsis or by failure to block thyroidal radioiodide uptake.  (+info)

Fluorescence studies on the interactions of barbaloin with bovine serum albumin. (59/342)

The fluorescence quenching reactions of barbaloin with bovine serum albumin (BSA) in pH 7.20 Tris-HCl buffer solution were studied. The quenching mechanism of BSA by barbaloin was interpreted using the Stern-Volmer (S-V) mechanism. The binding constant K values were 2.78 x 10(5) (293 K), 1.87 x 10(5) (310 K), 1.25 x 10(5) (318 K), and the number of binding sites (n) were 1.18, 1.14, and 1.09, respectively. In addition, the thermodynamic functions enthalpy (deltaH degrees ) and entropy (deltaS degrees ) for the reaction were also calculated according to Vant's Hoff equation were -23.7 kJ/mol and 23.6 J/mol, respectively. Plausible explanations of the quenching mechanism are discussed on the basis of a hydrophobic interaction between barbaloin and BSA.  (+info)

Fecal incontinence in elderly patients: common, treatable, yet often undiagnosed. (60/342)

It is important for primary care physicians to take fecal incontinence seriously and not dismiss it as a normal part of aging. Elderly patients may be reluctant to admit fecal incontinence, so clinicians need to ask about it. Two of the most common causes are fecal impaction (especially in nursing home patients) and rectosphincter dysfunction in people with diabetes.  (+info)

Patient preferences and side effects experienced with oral bowel preparations versus self-administered phosphate enema. (61/342)

Preparation of the bowel is necessary for adequate visualisation in barium enema and endoscopic investigations of the lower gastrointestinal tract. The preparations used are known to have side effects, but no previous study has asked patients who have experienced more than one different type of preparation which they prefer, and would have again in the future. A total of 71 patients who had experienced both phosphate enema and an oral bowel preparation (at different times) were sent a postal questionnaire asking what side effects they experienced, which preparation they preferred, and whether they would agree to have the preparation again. Of the 49 patients who responded (69%), most patients (61%) preferred an oral bowel preparation to a phosphate enema (39%). From these results we shall consider offering oral bowel preparation to patients who previously would have been offered an enema for flexible sigmoidoscopy.  (+info)

Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting. (62/342)

BACKGROUND: Gastro-oesophageal reflux disease (GERD) and constipation have a major impact on public health; however, the wide variety of treatment options presents difficulties for recommending therapy. Lack of definitive guidelines in pharmacy and general practice medicine further exacerbates the decision dilemma. AIMS: To address these issues, a panel of experts discussed the principles and practice of treating GERD and constipation in the general population and in pregnancy, with the aim of developing respective treatment guidelines. RESULTS: The panel recommended antacids 'on-demand' as the first-line over-the-counter treatment in reflux, and as rescue medication for immediate relief when reflux breaks through with proton pump inhibitors. Calcium/magnesium-based antacids were recommended as the treatment of choice for pregnant women because of their good safety profile. In constipation, current data do not distinguish a hierarchy between polyethylene glycol (PEG)-based laxatives and other first-line treatments, although limitations are associated with stimulant- and bulk-forming laxatives. Where data are available, PEG is superior to lactulose in terms of efficacy. In pregnancy, PEG-based laxatives meet the criteria for the ideal treatment. CONCLUSIONS: The experts developed algorithms that present healthcare professionals with clear treatment options and management strategies for GERD and constipation in pharmacy and general practice medicine.  (+info)

Effects of feeding a blend of grains naturally contaminated with Fusarium mycotoxins on feed intake, serum chemistry, and hematology of horses, and the efficacy of a polymeric glucomannan mycotoxin adsorbent. (63/342)

The feeding of Fusarium mycotoxin-contaminated grains adversely affects the performance of swine and poultry. Very little information is available, however, on adverse effects associated with feeding these mycotoxin-contaminated grains on the performance of horses. An experiment was conducted to investigate the effects of feeding a blend of grains naturally contaminated with Fusarium mycotoxins on feed intake, serum immunoglobulin (Ig) concentrations, serum chemistry, and hematology of horses. A polymeric glucomannan mycotoxin adsorbent (GM polymer) was also tested for efficacy in preventing Fusarium mycotoxicoses. Nine mature, nonexercising, light, mixed-breed mares were assigned randomly to one of three dietary treatments for 21 d. The horses were randomly reassigned and the experiment was subsequently replicated in time following a 14-d washout interval. Feed consumed each day was a combination of up to 2.8 kg of concentrates and 5 kg of mixed timothy/alfalfa hay. The concentrates fed included the following: 1) control, 2) blend of contaminated grains (36% contaminated wheat and 53% contaminated corn), and 3) blend of contaminated grains + 0.2% GM polymer. Diets containing contaminated grains averaged 15.0 ppm of deoxynivalenol, 0.8 ppm of 15-acetyldeoxynivalenol, 9.7 ppm of fusaric acid, and 2.0 ppm of zearalenone. Feed intake by all horses fed contaminated grains was reduced (P < 0.001) compared with controls throughout the experiment. Supplementation of 0.2% GM polymer to the contaminated diet increased (P = 0.004) feed intake of horses compared with those fed the unsupplemented contaminated diet. Serum activities of gamma-glutamyltransferase were higher (P = 0.047 and 0.027) in horses fed the diet containing contaminated grain compared with those fed the control diet on d 7 and 14, but not on d 21 (P = 0.273). Supplementation of GM polymer to the contaminated diet decreased (P < 0.05) serum gamma-glutamyltransferase activities of horses compared with those fed unsupplemented contaminated diet on d 7 and 14. Other hematology and serum chemistry measurements including serum IgM, IgG, and IgA, were not affected by diet. It was concluded that the feeding of grains naturally contaminated with Fusarium mycotoxins caused a decrease in feed intake and altered serum gamma glutamyltransferase activities. The supplementation of GM polymer prevented these mycotoxin-induced adverse effects.  (+info)

Evaluation of drug treatment in irritable bowel syndrome. (64/342)

The irritable bowel syndrome (IBS) remains a therapeutic challenge in part because of the limited understanding of the pathophysiology. The placebo response rate varies in randomized controlled trials from 20 to 70%, and can persist for up to at least 1 year. It is contentious whether dietary fibre and bulking agents relieve the symptoms of IBS; constipation probably improves. Anticholinergic and antispasmodic agents are of questionable benefit in IBS despite positive meta-analyses of poor quality trials. A meta-analysis concluded that the tricyclic antidepressants were superior to placebo in IBS, although the individual trial results were variable. Selective serotonin reuptake inhibitors are of uncertain benefit. Laxatives are used for constipation but probably poorly control the IBS symptom complex. Loperamide is superior to placebo in improvement of diarrhoea but not abdominal pain in IBS. Tegaserod is a well- tolerated aminoguanidine indole derivative of serotonin that is a partial 5HT4-receptor agonist with prokinetic properties; a therapeutic gain over placebo of 5% to 15% has been observed in constipation-predominant IBS in females. Alosetron is a 5HT3-receptor antagonist that is efficacious in females with diarrhoea-predominant IBS, with a 12% to 17% therapeutic gain; the risk of ischaemic colitis is 1 in 350, with very severe constipation occurring in about 1 in 1000. Optimizing study design remains a challenge in IBS. New visceral analgesic and motility modifying agents, as well as anti-inflammatory agents are in trials, and hopefully additional efficacious therapeutic options for patients with IBS will soon emerge.  (+info)