Digestive diseases
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Mastocytosis is a disease characterized by an abnormal increase in mast cells. Rare in occurrence, protean in its manifestations, it is a disease which is very seldom thought of and hence, possibly even overlooked. The last few decades have witnessed an upsurge in the understanding of the physiology and pathobiology of mast cells. ⋯ Once a diagnosis is established histamine antagonists remain the mainstay of treatment. Most patients live and die with the disease rather than of it. The objective of this review is to discuss this entity with a special focus on diagnosis and treatment.
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Appendicitis and its complications remain a common problem affecting patients of all age groups. Foreign bodies are a rare cause of appendicitis. We tried to define potentially dangerous foreign bodies that may cause appendicitis and summarize general guidelines for their clinical management. ⋯ Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects get into the appendiceal lumen they have a high risk for appendicitis or perforation. These foreign bodies are almost always radiopaque.
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Acute liver failure represents one of the most challenging conditions in gastroenterology. In most cases, there is no effective therapy making supportive intensive care the most important management tool. ⋯ Successful management of the patient with acute liver failure requires an understanding of the pathophysiology and management of these complications. An overview of acute liver failure and its most common complications is presented.
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It is now well recognized that the prevalence of delayed gastric emptying in both insulin-dependent as well as noninsulin-dependent diabetes mellitus is high. Recently performed studies have shown that motor disorders of several parts of the upper gastrointestinal tract contribute to this delay in gastric emptying. Traditionally, disordered motility in diabetes mellitus has been attributed to irreversible autonomic nerve damage. ⋯ These dyspeptic symptoms are not only induced by delayed gastric emptying, but altered visceroperception also plays a role in the genesis of dyspeptic symptoms. There is increasing evidence that impaired gastric emptying influences glycemia control, but the clinical consequences of these observations need further investigation. At present dyspeptic symptoms form the rationale for the treatment of delayed gastric emptying with prokinetic drugs.
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Normal rhythmic myoelectrical activity of the human stomach is 3 cpm, regulating gastric contractile activity. Dysrhythmia in gastric myoelectrical activity is found to be associated with functional disorders of the stomach. Gastric dysrhythmias are classified into tachygastria (frequency higher than normal), bradygastria (frequency lower than normal) and arrhythmia (no rhythmic activity). Clinical significance of gastric dysrhythmias is discussed in this paper, outlined as follows: (a) What is normal gastric myoelectrical activity and what is dysrhythmia? (b) How to detect gastric dysrhythmias? (c) Gastric dysrhythmias in clinical settings. (d) What may cause gastric dysrhythmias? (e) How to normalize gastric dysrhythmias?