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References: Laxative

temp/constipation-1.matches:surgery.ucsf.edu

BACKGROUND: Surgical referral of elderly patients with PHPT is often deferred because of the perceived risks of general anesthesia, increased age, and comorbidities and also because many of the symptoms of PHPT are difficult to distinguish from the aging process. HYPOTHESIS: Parathyroidectomy for primary hyperparathyroidism (PHPT) in elderly patients is beneficial and safe. DESIGN: Retrospective study of patients with PHPT who were 80 years and older. SETTING: Tertiary academic referral medical center. PATIENTS: Fifty-four consecutive patients (43 women and 11 men) with a mean age of 83.6 years who underwent parathyroidectomy for PHPT. MAIN OUTCOME MEASURES: Delay in surgical referral; improvement in symptoms and normalization of serum calcium and parathyroid hormone levels; and perioperative morbidity and mortality. RESULTS: Twelve (22%) of 54 patients had a mean delay of 5 years (range, 1.2-10.0 years) before surgical referral for a known diagnosis of PHPT. No patient had asymptomatic PHPT. There was no significant difference in the preoperative mean serum calcium level and symptoms of PHPT resulting from delay in surgical referral. Parathyroidectomy resulted in significant improvement of PHPT-associated symptoms of fatigue, weight loss, nocturia, bone pain, constipation, and major depression (P<.05). All patients had normal serum calcium and parathyroid hormone levels postoperatively. The average length of hospitalization was 1.9 days. There were 3 complications (9%): 1 urinary tract infection, 1 bladder perforation, and 3 transient hypocalcemia. There was no perioperative mortality. CONCLUSIONS: Parathyroidectomy in elderly patients is safe, curative, and beneficial. Surgical referral for

temp/constipation-1.matches:

J Pediatr. 2003 Jul;143(1):39-47.
A consistent pattern of minor immunodeficiency and subtle enteropathy in children with multiple food allergy.

Latcham F, Merino F, Lang A, Garvey J, Thomson MA, Walker-Smith JA, Davies SE, Phillips AD, Murch SH.

Centre for Paediatric Gastroenterology and Department of Dietetics and Histopathology, Royal Free and University College School of Medicine, London, United Kingdom.

OBJECTIVE: Although immunoglobulin (Ig)E-mediated allergies are readily identifiable, non-IgE-mediated allergies present more diagnostic difficulty. We performed a formal retrospective analysis to determine whether there is a recognizable clinical pattern in children. METHODS: We studied 121 children (mean age, 17.3 months) with multiple food allergies who were recruited on the basis of adequate immunological assessment by using case notes and parental questionnaire. RESULTS: Group 1 (n=44) had rapid reactions to dietary antigens, of whom 41 also showed delayed reactions. Group 2 (n=77) had delayed reactions only. Mean IgE was increased in group 1 but both groups otherwise shared a pattern of increased IgG1, decreased IgG2/4, and low-normal IgA. Lymphocyte subsets were skewed, with an increased percentage of CD4 and CD19 and decreased CD8 and natural killer cells. Gastroesophageal reflux, esophagitis, subtle enteropathy, and constipation were frequent in both groups. Of 55 exclusively breast-fed infants, 44 sensitized before weaning. Twenty-one of the mothers suffered from autoimmunity. CONCLUSIONS: There appears to be a recognizable pattern of immune deviation and minor enteropathy in children with multiple food allergy, irrespective of the speed of reactions. Disturbed gut motility is particularly common, as is a maternal history of autoimmunity.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12915822&dopt=Abstract

temp/constipation-1.matches:imperial.ac.uk

Cough is an important defensive reflex of the airway and a common symptom of respiratory disease. After an upper respiratory tract virus infection, cough is transient, but is more persistent with conditions such as asthma, rhinosinusitis, gastroesophageal reflux, chronic obstructive pulmonary disease (COPD) and lung cancer. Treatment directed at these conditions may improve cough, but there remains a need to control cough directly. The most effective antitussives are opioids, such as morphine, codeine or pholcodeine, but they produce side effects including drowsiness, nausea, constipation and physical dependence. Opioids such as k- and d-opioid receptor agonists, non-opioids such as nociceptin, neurokinin and bradykinin receptor antagonists, vanilloid receptor VR(1) antagonists, blockers of sodium-dependent channels, and maxi-K calcium-dependent channel activators of afferent nerves may all represent novel antitussives and this needs to be confirmed in clinical trials.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12917774&dopt=Abstract [PubMed - in process]

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