Spontaneous intramural rupture of the oesophagus
Traumatic esophageal injury is a common diagnosis in patients complaining of chest pain and hematemesis (vomiting blood) who have swallowed foreign bodies, engaged in forceful vomiting, or been examined with medical instruments such as an endoscope. When hematemesis has not occurred, the diagnosis is more difficult to make, especially when the pain mimics that typically experienced during a heart attack. The cases of seven patients with these symptoms who were treated between 1984 and 1988 are described. All of the patients reported experiencing pain in the center of the chest which could not be traced to ingestion of food or drink and which was followed (between 30 minutes and five hours later) by hematemesis. Cardiovascular evaluation ruled out the possibility of heart attack, which was the self-diagnosis made by most of the patients. Endoscopy (viewing the interior of the esophagus with a fiber-optic instrument) and radiological examination showed that there were long tears in the inner lining (mucosa) of the esophagus, and accumulated masses of blood in the walls of the esophagus (hematoma), but in no case was there a perforation of the wall of the esophagus. The cause of this phenomenon was not determined. These characteristics are similar to a previously reported condition, intramural esophageal rupture. Patients were treated with analgesics to manage pain, antihistamine compounds to reduce gastric acid secretion and, in some cases, were fed by tube in order to allow the esophagus to heal. All patients responded to this therapy, and were able to resume normal eating. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Treatment of staphylococcal septic arthritis in rabbits with systemic antibiotics and intra-articular corticosteroids
Corticosteroid injections into infected joints may improve the effectiveness of systemic antibiotics in septic arthritis. Researchers induced knee-joint infections with Staphylococcus epidermidis in rabbits, then treated them with systemic antibiotics. Some rabbits also received antiinflammatory corticosteroid injections into the joint space. Examination of the knee tissue revealed that the dual treatment protocol reduced damage to the joint tissues from infection, compared to antibiotics alone.
Publication Name: Annals of the Rheumatic Diseases
5-aminolevulinic acid photodynamic therapy versus argon plasma coagulation for ablation of BarrettEs oesophagus: a randomized trial
A study is conducted with the aim to compare 5-aminolevulinic acid induced photodynamic therapy (ALA-PDT) with argon plasma coagulation (APC) with respect to complete reversal of BarrettEs oesophagus (BO). The administration of APC or ALA-PDT in combination with APC in multiple treatment sessions results in complete reversal of BarrettEs epithelium in nearly two third of the patients.
Publication Name: Gut
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