Four patients with quiescent inflammatory bowel disease had prompt exacerbations when given nonsteroidal anti-inflammatory drugs. Nonsteroidal anti-inflammatory drugs can have noxious effects on the distal intestine as well as on the proximal gut. Eight previous cases of exacerbation of ulcerative colitis have been reported, as have instances of de-novo colitis and ileitis in persons treated with nonsteroidal anti-inflammatory drugs who did not have preexisting inflammatory bowel disease. Nonsteroidal anti-inflammatory drug ingestion should be considered in the differential diagnosis of inflammatory bowel disease. These drugs should be administered to patients with inflammatory bowel disease only after consideration of their possible harmful effects.
SUMMARYThe endogenous noradrenaline concentration, fractional turnover, half-life, and turnover rate of tritiated (3H) noradrenaline were determined in the oesophagus, non-glandular and glandular portions of the stomach, duodenum, jejunum, ileum, and colon of the rat. The highest concentration of endogenous noradrenaline was present in the duodenum and colon. The 3H-noradrenaline fractional turnover rates and half-lives were significantly greater in the small and large intestines as compared with the oesophagus and stomach. The noradrenaline turnover rate, which is an estimate of the level of sympathetic activity, was greatest in the colon and duodenum. This method of assessing sympathetic activity in various tissues by direct measurement of the noradrenaline turnover rate may be applied to the study of the adrenergic nervous system in the physiology and pathophysiology of the gastrointestinal tract.
A young diabetic patient with ketoacidosis responding to standard treatment abruptly developed pulmonary edema, apnea, coma, cardiac arrythmias and diabetes insipidus. At autopsy, cerebral edema and neuronal degeneration were present. In the hypothalamus many neurones were absent. Similar cases have been reported, but the pathogenesis of the syndrome is not understood. The present patient received large amounts of sodium bicarbonate, and significant potassium deficiency may have been present.
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