Database: MEDLINE <1966 to May Week 4 2002>
Search Strategy: (Gastrointestinal complaints in sports people)
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exp Gastrointestinal Diseases/ (419154)
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exp sports/ (42232)
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1 and 2 (384)
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limit 3 to english language (304)
5
limit 4 to yr=1996-2002 (114)
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exp *Gastrointestinal Diseases/ and 5 (68)
7
limit 6 to yr=1998-2002 (48)
8
limit 6 to review (6)
9
from 8 keep 1-6 (6)
10
from 8 keep 2,5-6 (3)
11
7 or 10 (50)
12
from 11 keep 1-50 (50)
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from 12 keep 1-50 (50)
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<1>
Unique Identifier
11151937
Medline Identifier
21025255
Authors
Nguyen MH. Ernsting KS. Proctor DD.
Title
Massive variceal bleeding caused by scuba diving.
Source
American Journal of Gastroenterology. 95(12):3677-8, 2000 Dec.
<2>
Unique Identifier
10364027
Medline Identifier
99290695
Authors
Peters HP. Bos M. Seebregts L. Akkermans LM. van Berge Henegouwen
GP. Bol E. Mosterd WL. de Vries WR.
Institution
Department of Medical Physiology and Sports Medicine, Utrecht
University, The Netherlands.
Title
Gastrointestinal symptoms in long-distance runners, cyclists, and
triathletes: prevalence, medication, and etiology.
Source
American Journal of Gastroenterology. 94(6):1570-81, 1999 Jun.
Abstract
OBJECTIVE: The aim of this study was to determine the prevalence of
exercise-related gastrointestinal (GI) symptoms and the use of medication
for these symptoms among long-distance runners, cyclists, and
triathletes, and to determine the relationship of different variables to
GI symptoms. METHODS: A mail questionnaire covering the preceding 12
months was sent to 606 well-trained endurance type athletes: 199 runners
(114 men and 85 women), 197 cyclists (98 men and 99 women), and 210
triathletes (110 men and 100 women) and sent back by 93%, 88%, and 71% of
these groups, respectively. Symptoms were evaluated with respect to the
upper (nausea, vomiting, belching, heartburn, chest pain) or lower part
of the GI tract (bloating, GI cramps, side ache, urge to defecate,
defecation, diarrhea). For statistical analysis, Mann-Whitney U test,
Fisher exact test, or Student t test were used. RESULTS: Runners
experienced more lower (prevalence 71%) than upper (36%) GI symptoms
during exercise. Cyclists experienced both upper (67%) and lower (64%)
symptoms. Triathletes experienced during cycling both upper (52%) and
lower (45%) symptoms, and during running more lower (79%) than upper
(54%) symptoms. Bloating, diarrhea, and flatulence occurred more at rest
than during exercise among all subjects. In general, exercise-related GI
symptoms were significantly related to the occurrence of GI symptoms
during nonexercise periods, age, gender, diet, and years of training. The
prevalence of medication for exercise-related GI symptoms was 5%, 6%, and
3% for runners, cyclists, and triathletes, respectively. CONCLUSIONS:
Long-distance running is mainly associated with lower GI symptoms,
whereas cycling is associated with both upper and lower symptoms.
Triathletes confirm this pattern during cycling and running. The
prevalence of medication for exercise-related GI symptoms is lower in the
Netherlands in comparison with other countries, in which a prevalence of
10-18% was reported. More research on the possible predisposition of
athletes for GI symptoms during exercise is needed.
<3>
Unique Identifier
9820403
Medline Identifier
99036289
Authors
Lucas W. Schroy PC 3rd.
Institution
Department of Medicine, Boston Medical Center, Massachusetts 02118,
USA.
Title
Reversible ischemic colitis in a high endurance athlete.
Source
American Journal of Gastroenterology. 93(11):2231-4, 1998 Nov.
Abstract
Ischemic colitis is a rare but serious consequence of long distance
running. Herein we report a well documented case of severe ischemic
colitis in an elite class marathon athlete in whom an extensive
diagnostic evaluation, including magnetic resonance angiography and
hypercoagulation profile, was performed. Our results suggest that
physiologic shunting due to splanchnic vasoconstriction, intravascular
volume depletion due to chronic dehydration, and possibly some element of
hypercoaguability due to secondary polycythemia may have been causative
factors. The patient's full recovery, both clinically and endoscopically,
with conservative treatment and ability to resume a vigorous training
schedule further support a reversible nonocclusive etiology.
<4>
Unique Identifier
10086654
Medline Identifier
99184458
Authors
Loudon CP. Corroll V. Butcher J. Rawsthorne P. Bernstein CN.
Institution
Faculty of Physical Education and Recreation Studies and Department of
Internal Medicine, University of manitoba, Winnipeg, Canada.
Title
The effects of physical exercise on patients with Crohn's disease.
Source
American Journal of Gastroenterology. 94(3):697-703, 1999 Mar.
Abstract
OBJECTIVE: Despite the suggested benefits of exercise training in the
prevention and management of chronic diseases, few data exist regarding
the safety of exercise in Crohn's disease and whether or not exercise may
have beneficial effects on patients' health. We performed a pilot study
to evaluate the effects of regular light-intensity exercise on sedentary
patients with Crohn's disease. METHODS: Sedentary patients with inactive
or mildly active Crohn's disease were eligible for the study. A thriceweekly, 12-wk walking program was supervised, although if subjects could
not attend the group walking sessions they were allowed to walk on their
own. Logbooks of performance were maintained, and individual exercise
heart rate goals were established. Measures performed at baseline and at
study completion included the Inflammatory Bowel Disease Stress Index,
the Inflammatory Bowel Disease Quality of Life Score, the Harvey and
Bradshaw Simple Index, the Canadian Aerobic Fitness Test, VO2 Max, and
body mass index (BMI). RESULTS: Twelve subjects completed the 12-wk
exercise program. Subjects walked an average of 2.9 sessions/wk, at an
average of 32.6 min/session, and for an average distance of 3.5
km/session. Statistically significant improvements at study end were seen
by all measures, with a trend toward reduction in BMI. No patient's
disease flared during the study. CONCLUSIONS: Sedentary patients with
Crohn's disease can tolerate low-intensity exercise of moderate duration
without an exacerbation of symptoms. Twelve weeks of walking was adequate
to elicit psychological and physical improvements and did not adversely
affect disease activity.
<5>
Unique Identifier
10327928
Medline Identifier
99259912
Authors
Ferron SM.
Title
Occult gastrointestinal bleeding with anorexia nervosa.
Source
American Journal of Psychiatry. 156(5):801, 1999 May.
<6>
Unique Identifier
11576991
Medline Identifier
21460353
Authors
Bass D.
Title
Duodenal haematoma occurs in children with bicycle injuries.
Source
BMJ. 323(7315):754-5, 2001 Sep 29.
<7>
Unique Identifier
10027060
Medline Identifier
99151122
Authors
Thomas RH. Thomas GO.
Title
Painful incarcerated hernia following a rugby union lineout.
Source
British Journal of Sports Medicine. 33(1):52-3, 1999 Feb.
Abstract
Discussion related to hernias in sport usually involves the diagnosis
and treatment of chronic musculotendinous groin disruption. A case of
acute trauma in an incarcerated inguinal hernia, occurring in a rugby
union player during a lineout, is presented. The injury arose as a result
of a change in the laws of the game.
<8>
Unique Identifier
9631220
Medline Identifier
98294681
Authors
Orchard JW. Read JW. Neophyton J. Garlick D.
Institution
School of Physiology and Pharmacology, University of New South Wales,
Sydney, Australia.
Title
Groin pain associated with ultrasound finding of inguinal canal
posterior wall deficiency in Australian Rules footballers.
Source
British Journal of Sports Medicine. 32(2):134-9, 1998 Jun.
Abstract
OBJECTIVES: To investigate the prevalence of inguinal canal posterior
wall deficiency (sports hernia) in professional Australian Rules
footballers using an ultrasound technique and correlate the results with
the clinical symptom of groin pain. METHODS: Thirty five professional
Australian footballers with and without groin pain were investigated
blind with a dynamic high resolution ultrasound technique for presence of
posterior wall deficiency. RESULTS: Fourteen players had a history of
significant recent groin pain and ten of these were found to have
bilateral inguinal canal posterior wall deficiency (p < 0.01). The
relative risk for a history of groin pain with bilateral deficiency was
8.0 (95% confidence interval 1.73 to 37.1). Groin pain was also found to
be associated with increasing age (p < 0.01) which was an independent
risk factor. Surgical, clinical, and ultrasound follow up for players who
underwent hernia repair confirmed the validity of ultrasound as a
diagnostic tool. CONCLUSIONS: Dynamic ultrasound examination is able to
detect inguinal canal posterior wall deficiency in young males with no
clinical signs of hernia. This condition is very prevalent in
professional Australian Rules footballers, including some who are
asymptomatic. There was a correlation between bilateral deficiency and
groin pain, although the temporal relationship between the clinical and
ultrasound findings is not established by the current study. Ultrasound
shows promise as a diagnostic tool in athletes with chronic groin pain
who are considered possible candidates for hernia repair.
<9>
Unique Identifier
10372020
Medline Identifier
99300608
Authors
Casey P. Casey MT.
Institution
Department of Surgery, Dalhousie University, Halifax, NS.
Title
Simultaneous pyloric and colonic obstruction associated with hiatus
hernia in a weightlifter: a case report.
Source
Canadian Journal of Surgery. 42(3):220-2, 1999 Jun.
Abstract
Hiatus hernia is usually attributed to conditions that cause a chronic
increase in intra-abdominal pressure such as multiple pregnancies and
obesity. A 30-year-old man, a weightlifter, had a massive hiatus hernia
causing both high and low gastrointestinal obstruction but no involvement
of the gastroesophageal junction or fundus. The onset of the obstruction
is attributed to an extreme increase in intra-abdominal pressure caused
by the action of lifting weights.
<10>
Unique Identifier
10463963
Medline Identifier
99393664
Authors
Tsang J. Ryan F.
Institution
University of British Columbia, Vancouver, Canada.
jtsang@interchange.ubc.ca
Title
Delayed diaphragmatic herniation masquerading as a complicated
parapneumonic effusion.
Source
Canadian Respiratory Journal. 6(4):361-6, 1999 Jul-Aug.
Abstract
Injury to the diaphragm following blunt or penetrating thoracoabdominal
trauma is not uncommon. Recognition of this important complication of
trauma continues to be a challenge because of the lack of specific
clinical and plain radiographic features, the frequent presence of other
serious injuries and the potential for delayed presentation. Delayed
diaphragmatic herniation often presents with catastrophic bowel
obstruction or strangulation. Early recognition of diaphragmatic injury
is required to avoid this potentially lethal complication. The case of a
35-year-old man with a history of a knife wound to the left flank 15
years previously, who presented with unexplained acute hypoxemic
respiratory failure and a unilateral exudative pleural effusion that was
refractory to tube thoracostomy drainage, is reported. After admission to
hospital, he developed gross dilation of his colon; emergency laparotomy
revealed an incarcerated colonic herniation into the left hemithorax.
Interesting clinical features of this patient's case included the
patient's hobby of weightlifting, a persistently deviated mediastinum
despite drainage of the pleural effusion and deceptive pleural fluid
biochemical indices.
<11>
Unique Identifier
10717609
Medline Identifier
20183509
Authors
Ramsey SD. Andersen MR. Etzioni R. Moinpour C. Peacock S. Potosky
A. Urban N.
Institution
Department of Medicine, University of Washington, Seattle, Washington,
USA.
Title
Quality of life in survivors of colorectal carcinoma.
Source
Cancer. 88(6):1294-303, 2000 Mar 15.
Abstract
BACKGROUND: Colon carcinoma is a common malignancy that accounts for a
substantial share of all cancer-related morbidity and mortality. However,
little is known with regard to general and disease specific quality of
life in survivors of colorectal carcinoma, particularly from communitybased samples of cases across stage and survival times from diagnosis.
METHODS: Subjects with colorectal carcinoma were recruited from the
National Cancer Institute's Surveillance, Epidemiology, and End Results
cancer registry. Subjects completed two self-administered surveys: the
Functional Assessment of Cancer Therapy Scales for Colorectal Cancer
(FACT-C) and the Health Utilities Index (HUI) Mark III. RESULTS: One
hundred seventy-three respondents (average age: 70.4 years, 71.4% female)
completed the survey. In the first 3 years after diagnosis, quality of
life was lower and varied substantially among respondents. After 3 years,
respondents in all TNM stages of disease except Stage IV reported a
relatively uniform and high quality of life. Pain, functional well-being,
and social well-being were affected most substantially across all stages
and times from diagnosis. Low income status was associated with worse
outcomes for pain, ambulation, and social and emotional well-being. Only
emotional well-being scores improved significantly over time in both
surveys. CONCLUSIONS: Those individuals who achieve a long term remission
from colorectal carcinoma may experience a relatively high quality of
life, although deficits remain for several areas, particularly in those
of low socioeconomic status. Sampling design may have excluded the most
severely ill patients. Copyright 2000 American Cancer Society.
<12>
Unique Identifier
9448949
Medline Identifier
98110437
Authors
Lacroix VJ. Kinnear DG. Mulder DS. Brown RA.
Institution
Department of Family Medicine, McGill University, Montreal, Quebec,
Canada.
Title
Lower abdominal pain syndrome in national hockey league players: a
report of 11 cases.
Source
Clinical Journal of Sport Medicine. 8(1):5-9, 1998 Jan.
Abstract
PURPOSE: Groin injuries are a major diagnostic and therapeutic
challenge in sports medicine. The aim of this review is to describe the
clinical and surgical findings associated with an atypical lower
abdominal pain syndrome occurring in elite ice hockey players. CASE
SUMMARIES: Eleven professional ice hockey players from various National
Hockey League teams were referred to the Montreal General Hospital
between 1989 and 1996, suffering from atypical refractory pain and
paraesthesia in the lower abdomen. Despite the use of conventional
investigative procedures such as physical examination, ultrasound, bone
scan, computed tomography scan, and magnetic resonance imaging scan,
preoperative findings were consistently negative. Operative findings
revealed varying degrees of tearing of the external oblique aponeurosis
and external oblique muscle associated with ilioinguinal nerve
entrapment. Repair of the external oblique tear, ablation of the
ilioinguinal nerve, followed by a 12-week planned course of physiotherapy
allowed all to return to professional ice hockey careers. DISCUSSION:
While soft tissue injuries are the most common cause of groin pain in the
athlete, tears of the external oblique aponeurosis and superficial
inguinal ring have rarely been cited as a consistent cause of lower
abdominal pain in athletes. Inguinal nerve entrapment is also rare in
patients without a history of previous lower abdominal surgery.
RELEVANCE: These 11 cases emphasize the importance of including another
diagnostic possibility in the differential diagnosis of chronic overuse
injuries of the lower abdomen.
<13>
Unique Identifier
10442629
Medline Identifier
99369233
Authors
Archer MC.
Title
Use of oral creatine to enhance athletic performance and its potential
side effects. [letter; comment.].
Comments
Comment on: Clin J Sport Med. 1998 Oct;8(4):286-97 ; 9884793, Comment
on: Clin J Sport Med. 1998 Oct;8(4):298-304 ; 9884794
Source
Clinical Journal of Sport Medicine. 9(2):119, 1999 Apr.
<14>
Unique Identifier
10600658
Medline Identifier
20069285
Authors
Jeukendrup AE. Vet-Joop K. Sturk A. Stegen JH. Senden J. Saris WH.
Wagenmakers AJ.
Institution
Department of Human Biology, Maastricht University, P.O. Box 616, 6200
MD Maastricht, The Netherlands. A.E.Jeukendrup@bham.ac.uk
Title
Relationship between gastro-intestinal complaints and endotoxaemia,
cytokine release and the acute-phase reaction during and after a longdistance triathlon in highly trained men.
Source
Clinical Science. 98(1):47-55, 2000 Jan.
Abstract
The aim of the present study was to establish whether gastro-intestinal
(GI) complaints observed during and after ultra-endurance exercise are
related to gut ischaemia-associated leakage of endotoxins
[lipopolysaccharide (LPS)] into the circulation and associated cytokine
production. Therefore we collected blood samples from 29 athletes before,
immediately after, and 1, 2 and 16 h after a long-distance triathlon for
measurement of LPS, tumour necrosis factor-alpha and interleukin-6 (IL6). As the cytokine response would trigger an acute-phase response,
characteristic variables of these responses were also measured, along
with creatine kinase (CK) to obtain an indicator of muscle damage. There
was a high incidence (93% of all participants) of GI symptoms; 45%
reported severe complaints and 7% of the participants abandoned the race
because of severe GI distress. Mild endotoxaemia (5-15 pg/ml) was evident
in 68% of the athletes immediately after the race, as also indicated by a
reduction in IgG anti-LPS levels. In addition, we observed production of
IL-6 (27-fold increase immediately after the race), leading to an acutephase response (20-fold increase in C-reactive protein and 12% decrease
in pre-albumin 16 h after the race). The extent of endotoxaemia was not
correlated with the GI complaints or the IL-6 response, but did show a
correlation with the elevation in C-reactive protein (r(s) 0.389;
P=0.037). Creatine kinase levels were increased significantly immediately
post-race, and increased further in the follow-up period. Creatine kinase
levels did not correlate with those of either IL-6 or C-reactive protein.
It is therefore concluded that LPS does enter the circulation after
ultra-endurance exercise and may, together with muscle damage, be
responsible for the increased cytokine response and hence GI complaints
in these athletes.
<15>
Unique Identifier
11022390
Medline Identifier
20476964
Authors
Stafford R. Neville G. Towner C. McCall B.
Institution
Brisbane Southside Public Health Unit, Coopers Plains, Queensland.
russell_stafford@health.qld.gov.au
Title
A community outbreak of Cryptosporidium infection associated with a
swimming pool complex.
Source
Communicable Diseases Intelligence. 24(8):236-9, 2000 Aug.
Abstract
A case-control study was conducted to investigate the cause of a sudden
increase in cases of cryptosporidiosis notified to the Brisbane Southside
Public Health Unit from January to March 1998. Fifty-two eligible cases
were identified over a three-week period early in 1998. Thirty-one of
these cases and 21 control subjects participated in the study. Swimming
in the 2 weeks before onset of illness was identified as a likely risk
factor for cryptosporidiosis infection (OR 3.1, CI 0.8-12.6, P = 0.06).
Analysis of swimming pool attendance identified swimming at Pool Complex
A as a significant risk factor for the acquisition of cryptosporidiosis
(OR 8.9, CI 1.5-67.4, P = 0.004). No other potential risk factors were
significantly associated with illness. The detection of cryptosporidium
oocysts in three of the four pools at Pool Complex A supported the
findings of the case-control study. As a response to this outbreak,
Queensland Health has developed a Code of Practice outlining measures for
the control and prevention of future outbreaks of swimming poolassociated cryptosporidiosis and/or giardiasis.
<16>
Unique Identifier
11828558
Medline Identifier
21686027
Authors
Petri NM. Vranjkovic-Petri L.
Institution
Aras N.
Druzijanic N.
Undersea and Hyperbaric Medicine Department, Naval Medical Institute,
P.O. 196 (HRM), 21000 Split, Croatia. nadan.petri@morh.hr
Title
Gastric rupture in a diver due to rapid ascent.
Source
Croatian Medical Journal. 43(1):42-4, 2002 Feb.
Abstract
A 37-year-old, experienced female diver developed gastric rupture due
to rapid ascent from a depth of 37 meters. The incident was preceded by a
heavy meal, intake of soda beverages, swallowing of air and water under
water, and panic. Sharp abdominal pain was present immediately after
surfacing and afterwards. Full abdominal distension developed within two
hours after the ascent. No other diving-related pathology was found.
Surgery was performed around three hours after the accident and revealed
pneumoperitoneum, gastric rupture, gastric content in the abdomen cavity,
and signs of acute peritonitis. On surgery, a 4-cm rupture of the lesser
curvature was found and sutured. The patient was discharged eight days
after the event.
<17>
Unique Identifier
9747762
Medline Identifier
98418534
Authors
Furtado C. Adak GK. Stuart JM. Wall PG. Evans HS. Casemore DP.
Institution
PHLS Communicable Disease Surveillance Centre, London, UK.
Title
Outbreaks of waterborne infectious intestinal disease in England and
Wales, 1992-5.
Source
Epidemiology & Infection. 121(1):109-19, 1998 Aug.
Abstract
Following the introduction of an improved surveillance system for
infectious intestinal disease outbreaks in England and Wales, the Public
Health Laboratory Service Communicable Disease Surveillance Centre
received reports of 26 outbreaks between 1 January 1992 and 31 December
1995 in which there was evidence for waterborne transmission of
infection. In these 26 outbreaks, 1756 laboratory confirmed cases were
identified of whom 69 (4%) were admitted to hospital. In 19 outbreaks,
illness was associated with the consumption of drinking water from public
supplies (10 outbreaks) or private supplies (9 outbreaks). The largest
outbreak consisted of 575 cases. In 4 of the remaining 7 outbreaks,
illness was associated with exposure to swimming pool water.
Cryptosporidium was identified as the probable causative organism in all
14 outbreaks associated with public water supplies and swimming pools.
Campylobacter was responsible for most outbreaks associated with private
water supplies. This review confirms a continuing risk of
cryptosporidiosis from chlorinated water supplies in England and Wales,
and reinforces governmental advice to water utilities that water
treatment processes should be rigorously applied to ensure effective
particle removal. High standards of surveillance are important for prompt
recognition of outbreaks and institution of control measures. As
microbiological evidence of water contamination may be absent or
insufficient to implicate a particular water supply, a high standard of
epidemiological investigation is recommended in all outbreaks of
suspected waterborne disease.
<18>
Unique Identifier
10098778
Medline Identifier
99196414
Authors
Paunio M. Pebody R. Keskimaki M. Kokki M. Ruutu P. Oinonen S.
Vuotari V. Siitonen A. Lahti E. Leinikki P.
Institution
University of Helsinki, Department of Public Health, Mannerheimintie,
Finland.
Title
Swimming-associated outbreak of Escherichia coli O157:H7.
Source
Epidemiology & Infection. 122(1):1-5, 1999 Feb.
Abstract
In 1997 the first outbreak of Escherichia coli O157:H7 infections
involving 14 cases occurred in Finland. A case was defined as a resident
of Alavus with an episode of diarrhoea between 5 and 17 July 1997, and
from whom E. coli O157:H7 was isolated from stool. The investigation
included case searching and a population-based case control study. Five
primary and eight symptomatic secondary cases of E. coli O157:H7 illness
were detected. In the 10 days before the outbreak, all 5 primary patients
(aged 3-8 years), but only 6 of 32 population controls from the same age
range (Fisher's test, P < 0.001) and 4 of 10 sibling controls (P < 0.05)
had visited (but had not necessarily bathed in) a shallow beach popular
among young children. Four out of 5 primary cases had remained within 5 m
of the beach while swimming and had swallowed lake water compared to 1 of
5 population controls. These analytical epidemiologic findings
incriminated fresh lake water as the vehicle of E. coli O157:H7
transmission.
<19>
Unique Identifier
11467796
Medline Identifier
21360426
Authors
Puech MC. McAnulty JM. Lesjak M. Shaw N. Heron L. Watson JM.
Institution
Department of Public Health and Community Medicine, Westmead Hospital,
NSW, Australia.
Title
A statewide outbreak of cryptosporidiosis in New South Wales associated
with swimming at public pools.
Source
Epidemiology & Infection. 126(3):389-96, 2001 Jun.
Abstract
From December 1997 to April 1998, 1060 laboratory-confirmed
cryptosporidiosis cases were reported in New South Wales, Australia. In a
case-control study, compared with 200 controls, the 100 cases were
younger (mean age 42 versus 71 years; P < 0.0001), more likely to report
swimming at a public pool (59% versus 38%; adjusted OR and 95% CI = 27;
1.4-5.1) and swimming in a dam, river or lake (OR = 48; 1.1-20.3) but
less likely to report drinking bottled water (OR = 0.4; 0.2-0.9). In
subgroup analyses, in rural areas illness was associated mainly with
contact with another person with diarrhoea, and in urban areas illness
was associated with swimming in a public pool. Cryptosporidium oocysts
were more commonly detected in pools to which at least two notified cases
had swum (P = 004). Outbreaks of cryptosporidiosis can be prolonged,
involve multiple pools and be difficult to control.
<20>
Unique Identifier
11564961
Medline Identifier
21448508
Authors
Choi SC. Choi SJ. Kim JA. Kim TH. Nah YH. Yazaki E. Evans DF.
Institution
Department of Gastroenterology, Wonkwang University School of Medicine
and Wonkwang Health Science College, Iksan, Korea.
Title
The role of gastrointestinal endoscopy in long-distance runners with
gastrointestinal symptoms.
Source
European Journal of Gastroenterology & Hepatology. 13(9):1089-94, 2001
Sep.
Abstract
BACKGROUND: Exercise-related gastrointestinal symptoms are not uncommon
among athletes. The occurrence of gastrointestinal bleeding has been
reported, especially in long-distance runners. We studied
gastrointestinal mucosal damage, using gastrointestinal endoscopy, in
competitive long-distance runners. Gastrointestinal blood loss and
anaemia before and after running were also assessed. METHODS: Sixteen
competitive long-distance runners (all men; age range 16-19 years)
participated in the study. All runners completed a symptom questionnaire
prior to a 20 km race. Stool occult blood and haematological studies
(haemoglobin, haematocrit, serum iron, total iron-binding capacity [TIBC]
and ferritin) were performed before and immediately after the race.
Gastrointestinal endoscopy was performed to assess macroscopic changes.
Colonoscopy was also performed on the patients who had positive stool
occult blood before or after the race. RESULTS: Gastrointestinal symptoms
were frequently experienced by the runners. Gastritis (n = 16),
oesophagitis (n = 6) and gastric ulcer (n = 1) were found at gastroscopy.
Colonoscopy was performed on four patients who had positive stool occult
blood. One had multiple erosions at the splenic flexure and one had a
rectal polyp. Five runners had anaemia, and all of these had at least one
endoscopic lesion (three gastritis, two oesophagitis and one multiple
erosion at the splenic flexure). There were significant changes in the
following haematological parameters after the race: iron (decreased, P =
0.02), ferritin (decreased, P = 0.001) and TIBC (increased, P = 0.00005).
CONCLUSIONS: Gastrointestinal symptoms and gastrointestinal mucosal
damage are prevalent among long-distance runners. Prior to treatment,
gastrointestinal endoscopy should be considered in long-distance runners
with gastrointestinal symptoms and/or anaemia.
<21>
Unique Identifier
10532269
Medline Identifier
20000069
Authors
Pomberger G. Hallwirth U. Pumberger W. Horcher E.
Institution
Department of Surgery, University of Vienna, Medical School,
Austria/Europe.
Title
Short-bowel syndrome associated with subtotal necrosis of small
intestine after rectal trauma.
Source
European Journal of Pediatric Surgery. 9(4):251-2, 1999 Aug.
Abstract
We report on a 4-year-old girl who experienced rectal trauma during
swimming, sitting on an uncovered draining valve in the swimming pool.
This resulted in a powerful suction effect on her rectum, followed by
rupture of the sigmoid colon and evisceration of the small intestine.
Laparotomy showed a near complete necrosis of the small bowel because of
thrombotic lesions and wall lacerations of the superior mesenteric artery
(SMA). A subtotal bowel removal associated with a jejuno-ileostoma was
carried out, a total length of about 35 cm of the small intestine could
be left in situ. Parenteral nutrition was stopped after eight months. At
the moment defecation takes place 2-3 times a day, growth and weight gain
are quite normal.
<22>
Unique Identifier
10908752
Medline Identifier
20370868
Authors
Cullinane DC.
Institution
Mayo Clinic and Mayo Foundation, Department of Surgery, Division of
Gastrointestinal and General Surgery, 200 First Street, SW, Rochester, MN
55905, USA.
Title
Incarcerated, strangulated handlebar hernia.
Source
Injury. 31(7):551-3, 2000 Sep.
<23>
Unique Identifier
10404059
Medline Identifier
99352334
Authors
Tang R. Wang JY. Lo SK. Hsieh LL.
Institution
Colorectal Section, Department of Surgery, Chang Gung Medical Center,
Tao-Yuan, Taiwan.
Title
Physical activity, water intake and risk of colorectal cancer in
Taiwan: a hospital-based case-control study.
Source
International Journal of Cancer. 82(4):484-9, 1999 Aug 12.
Abstract
The age-adjusted mortality rates of colorectal cancer have been rising
in Taiwan over the past 2 decades, and colorectal cancer is now the third
leading cause of cancer mortality in the country. We conducted a
hospital-based case-control study to clarify the nature of the
association between physical activity, water intake and colorectal-cancer
risk in Taiwan. A total of 163 subjects (aged 33-80 years) with
histologically confirmed primary colorectal cancer and 163 hospital
controls were enrolled during 1992. Dietary intake, physical activity and
other lifestyle activities were assessed using a comprehensive foodfrequency and lifestyle-activity questionnaire. Adjusted odds ratios (OR)
and 95% confidence intervals (CI) were estimated using conditional
logistic-regression analysis. A strong inverse dose-response relation
between increased water intake and rectal cancer was found among men
after adjustment for other risk factors (p for trend = 0.0005). The OR
for rectal cancer among men in the highest tertile of water intake was
0.08 (95% CI, 0.02-0.35) compared with that among men in the lowest
tertile (OR = 1). Similar but not significant trends were seen among
women (p = 0.29). The OR for colon cancer among men with active leisuretime physical activity was 0.19 (95% CI, 0.05-0.77) times that among
sedentary men (p for trend = 0.03). However, physical activity was not
associated with colon-cancer risk among women (p = 0.48). No differences
in the amount of water intake were found related to level of physical
activity. These findings add to the evidence that leisure-time activity
may reduce colon-cancer risk, not only in high-risk but also in low-risk
populations, and support the potential beneficial effect of increased
water intake in reducing colorectal-cancer risk. Copyright 1999 WileyLiss, Inc.
<24>
Unique Identifier
9602415
Medline Identifier
98265125
Authors
van Asperen IA. Medema G.
Institution
Borgdorff MW.
Sprenger MJ.
Havelaar AH.
Department of Infectious Diseases Epidemiology, National Institute of
Public Health and the Environment, Bilthoven, The Netherlands.
Title
Risk of gastroenteritis among triathletes in relation to faecal
pollution of fresh waters.
Source
International Journal of Epidemiology. 27(2):309-15, 1998 Apr.
Abstract
BACKGROUND: We conducted a prospective cohort study among endurance
athletes to investigate the effects of microbiological water quality on
the risk of gastroenteritis after bathing in fresh waters that meet
current water quality standards. We aimed to establish quantitative
relationships, in order to evaluate current bathing water standards.
METHODS: The study was spread over two summers, during which 827
triathletes (swimmers) in seven Olympic distance triathlons and 773
participants in 15 run-bike-runs (non-swimming controls) participated.
Intensive water quality monitoring was used to assess exposure to faecal
indicator organisms and detailed questionnaires were used to collect data
on the occurrence of health complaints and potential confounding factors.
RESULTS: The microbiological water quality at the time of the triathlons
met current Dutch and European bathing water standards. Dependent on the
case definition studied, gastroenteritis developed in 0.4-5.2% of
swimmers and 0.1-2.1% of non-swimmers in the week following exposure
(odds ratio [OR] = 1.6-2.3). Attack rates and burden of disease varied
with the case definition used. Among swimmers, the attack rate of
gastroenteritis was significantly increased when the geometric mean
concentration of thermotolerant coliforms in the water at the time of
exposure was > or = 220/100 ml or the geometric mean concentration of
Escherichia coli was > or = 355/100 ml (OR comparing high versus low
exposure 2.9-4.7 dependent on the case definition studied).
Thermotolerant coliform concentrations at these triathlons ranged from
100/100 ml (the EU guide level) to 960/100 ml (the EU imperative level is
2000/100 ml). Below the threshold levels attack rates were comparable
with attack rates among non-swimmers. A relation with other indicators of
faecal pollution was not observed. CONCLUSIONS: We observed that swimming
in fresh waters that met the European imperative level for thermotolerant
coliforms but failed the European guide level was associated with a
significant risk of gastroenteritis among triathletes. This means that
the current European imperative level for thermotolerant coliforms
provides insufficient protection to gastrointestinal illness for those
who are comparable with triathletes.
<25>
Unique Identifier
9563686
Medline Identifier
98223175
Authors
Pruss A.
Institution
World Health Organization, Urban Environmental Health, Division of
Operational Support in Environmental Health, Geneva, Switzerland.
Title
Review of epidemiological studies on health effects from exposure to
recreational water. [Review] [46 refs]
Source
International Journal of Epidemiology. 27(1):1-9, 1998 Feb.
Abstract
BACKGROUND: In order to facilitate the setting of guidelines, this
review article evaluates the health risks caused by poor microbiological
quality of recreational natural water. METHODS: Studies on uncontrolled
waters, such as sea, lakes and rivers were considered in this review
through MEDLINE and WHO resources. Out of the 37 studies identified, 22
were reviewed because they addressed associations of interest and
fulfilled the validity criteria. RESULTS: Most studies reported a doserelated increase of health risk in swimmers with an increase in the
indicator-bacteria count in recreational waters. Relative risk (RR)
values for swimming in polluted water versus clean water were often
significant (usually 1.0 < RR < 3.0). The indicator microorganisms that
correlate best with health outcomes were enterococci/faecal streptococci
for both marine and freshwater, and Escherichia coli for freshwater. In
both marine and freshwater, increased risk of gastro-intestinal symptoms
was reported for water quality values ranging from only a few indicator
counts/100 ml to about 30 indicator counts/100 ml. These values are low
compared with the water qualities frequently encountered in coastal
recreational waters. Studies which showed a higher threshold for
increased risk and case-rate values in some countries may suggest
immunity due to endemicity or a lower pathogen-to-indicator ratio in the
natural waters. CONCLUSIONS: The review strongly suggests a causal doserelated relationship between gastrointestinal symptoms and recreational
water quality measured by bacterial indicator counts. [References: 46]
<26>
Unique Identifier
10452229
Medline Identifier
99379298
Authors
Buchman AL. O'Brien W. Ou CN. Rognerud C. Alvarez M. Dennis K.
Ahn C.
Institution
Division of Gastroenterology, Hepatology and Nutrition, University of
Texas Houston Health Science Center, USA. abuchman@heart-med.uth.tmc.edu
Title
The effect of arginine or glycine supplementation on gastrointestinal
function, muscle injury, serum amino acid concentrations and performance
during a marathon run.
Source
International Journal of Sports Medicine. 20(5):315-21, 1999 Jul.
Abstract
Gastrointestinal bleeding and increased intestinal permeability have
been observed in marathon runners. We sought to determine if L-arginine
would be useful for prevention of these complications. Twenty-three
runners were randomized to receive L-arginine (A) or glycine (placebo)
(G), 10 grams 3 times daily for 14 days prior to the 1997 HoustonMethodist Marathon. Serum, stool hemoccults and lactulose:mannitol
permeabilities were obtained at baseline, immediately after completion of
the marathon and approximately 48 hours later. Runners rated their
symptoms of nausea and vomiting, belching and indigestion, abdominal pain
and bloating, diarrhea, and extremity pain on a 1-5 scale of increasing
severity. The L:M was unchanged in either group during the three
collections. Occult bleeding occurred in 8%/20% in A and G groups,
respectively, p = NS) immediately post-marathon. No runners had occult
bleeding 48 hours post-race. Gastrointestinal symptom scores were minimal
to nonexistent. Extremity pain scores were similar for groups A and G
(2.11.4 and 2.81.6, respectively, (p = NS). Fluid intake was similar
between both groups (18751547 vs. 1506970 ml, p = NS). Serum amylase was
normal at baseline and remained virtually unchanged. Serum lipase was
normal at baseline and immediately post-race in both groups, but
increased at 48 hours post-race (82.234.3 to 121.553.3 mg/dl [A], p =
0.02 and 114.355.7 to 181.9162.2 mg/dl [G], p = 0.09). CPK increased
significantly and similarly in both groups immediately post-race, and
even more dramatically 48 hours post-race (130.3130.8 to 738.8902.9, p =
0.007 to 1966.53.166.0 mg/dl [A] and 140.977.9 to 863.0772.3, p = 0.003
to 561910636.8mg/dl [G]). Modest post-race decreases were seen in most
serum amino acids in both groups. Finish times were longer than predicted
(2321 and 97 min for A and G groups, respectively, p = 0.049). Our study
failed to show a clear benefit of arginine supplementation for the
prevention of intestinal ischemia/reperfusion injury associated with
endurance running, but either a detrimental affect on performance with
arginine, or enhanced performance with glycine. Skeletal muscle injury
was unaffected by arginine or glycine supplementation. The delayed
increase in serum lipase suggests mild pancreatic injury, affected by
either arginine or glycine supplementation.
<27>
Unique Identifier
9570057
Medline Identifier
98231576
Authors
Hunter JD. Roobottom CA. Bryson PJ. Brown C.
Institution
Directorate of Imaging, Derriford Hospital, Plymouth, UK.
Title
Conservative management of gastric rupture following scuba diving.
Source
Journal of Accident & Emergency Medicine. 15(2):116-7, 1998 Mar.
Abstract
Gastric rupture is an uncommon surgical problem which normally presents
with an acute abdomen and peritonism. An unusual case following
underwater ascent and its conservative management is presented.
<28>
Unique Identifier
10372935
Medline Identifier
99300150
Authors
Smith AB. Dickerman RD. McGuire CS. East JW. McConathy WJ. Pearson
HF.
Institution
Department of Surgery, University of North Texas Health Science Center,
Fort Worth 76107-2699, USA.
Title
Pressure-overload-induced sliding hiatal hernia in power athletes.
Source
Journal of Clinical Gastroenterology. 28(4):352-4, 1999 Jun.
Abstract
Sliding hiatal hernias are a common condition thought to occur with
increasing age secondary to a degenerative process. The incidence of
sliding hiatal hernias in the general population is 0.5%. Although the
prevalence in the Western world is thought to be significantly higher,
with approximately 60% of geriatric patients in North America having a
hiatal hernia on radiologic studies. Thus, the primary etiology of the
sliding hiatal hernia is thought to be degeneration of the
phrenoesophageal ligament. Most hiatal hernias occurring in young adults
are idiopathic. There has been speculation of a stress-induced hiatal
hernia from repeated episodes of elevated intra-abdominal pressure, and
to date there is one report of a pressure-overload-induced hiatal hernia
occurring in an elite body builder. The prevalence of hiatal hernia in
young male power athletes has yet to be examined. Therefore, we examined
eight male elite power athletes and seven male non-weightlifters, matched
for age, via fluoroscopy with barium swallow to test the hypothesis that
pressure overload can induce hiatal hernias in young adults.
<29>
Unique Identifier
9412919
Medline Identifier
98074399
Authors
Dickerman RD. McConathy WJ. Smith AB.
Institution
Department of Medicine, University of North Texas Health Science
Center, Fort Worth 76107-2699, USA.
Title
Can pressure overload cause sliding hiatal hernia? A case report and
review of the literature. [Review] [29 refs]
Source
Journal of Clinical Gastroenterology. 25(1):352-3, 1997 Jul.
Abstract
We describe a hiatal hernia of moderate size in a 31-year-old
competitive bodybuilder to raise the question of whether such hernias are
more likely in young elite resistance-trained athletes as a consequence
of attempts to increase intra-abdominal pressure and thus decrease the
strain on the lumbar spine. [References: 29]
<30>
Unique Identifier
11694361
Medline Identifier
21551299
Authors
Grover JK. Adiga G. Vats V. Rathi SS.
Institution
Department of Pharmacology, All India Institute of Medical Sciences,
Ansari Nagar, 110029, New Delhi, India. jkgrover@hotmail.com
Title
Extracts of Benincasa hispida prevent development of experimental
ulcers.
Source
Journal of Ethnopharmacology. 78(2-3):159-64, 2001 Dec.
Abstract
Benincasa hispida (B. hispida) is recommended in Ayurveda for the
management of peptic ulcers. Therefore, anti-ulcerogenic activity of
different extracts of B. hispida (fresh juice, supernatant and residue
fraction of centrifuged juice, alcoholic and petroleum ether extract)
were studied in aspirin plus restraint, swimming stress, indomethacin
plus histamine and serotonin-induced ulcers in rats and mice. The oral
feeding of different doses of the extract significantly reduced the ulcer
index produced by various ulcerogens. The anti-ulcerogenic effect was
dose-dependent in stress induced model of ulcer and not in other models.
B. hispida probably has a CNS component in prevention of stress induced
ulceration. However, antihistaminic, anti-cholinergic effects and
prevention of disturbance in gastric micro-circulation as possible modes
of action cannot be ruled out. Chronic toxicity studies carried out for 3
months revealed no deleterious effect of fresh juice of B. hispida on
various hematological and biochemical parameters studied. Thus, extracts
of B. hispida may be considered to be a drug of natural origin possessing
anti-ulcer activity.
<31>
Unique Identifier
10204621
Medline Identifier
99219315
Authors
Maemura T. Yamaguchi Y. Yukioka T. Matsuda H. Shimazaki S.
Institution
Department of Traumatology and Critical Care Medicine, Kyorin
University, Tokyo, Japan.
Title
Laparoscopic drainage of an intramural duodenal hematoma.
Source
Journal of Gastroenterology. 34(1):119-22, 1999 Feb.
Abstract
A 21-year-old man was admitted with vomiting and abdominal pain 3 days
after sustaining blunt abdominal trauma by being tackled in a game of
American football. A diagnosis of intramural hematoma of the duodenum was
made using computed tomography and upper gastrointestinal tract contrast
radiography. The hematoma caused obstructive jaundice by compressing the
common bile duct. The contents of the hematoma were laparoscopically
drained. A small perforation was then found in the duodenal wall. The
patient underwent laparotomy and repair of the injury. Laparoscopic
surgery can be used as definitive therapy in this type of abdominal
trauma.
<32>
Unique Identifier
10619502
Medline Identifier
20084520
Authors
Brown PD. Stafford SL. Schild SE. Martenson JA. Schiff D.
Institution
Division of Radiation Oncology, Mayo Clinic and Mayo Foundation,
Rochester, MN 55905, USA.
Title
Metastatic spinal cord compression in patients with colorectal cancer.
Source
Journal of Neuro-Oncology. 44(2):175-80, 1999 Sep.
Abstract
BACKGROUND: A retrospective study was performed to examine the outcome
of patients with colorectal cancer who had metastatic spinal cord
compression (MSCC) and received radiation therapy (RT). METHODS: Forty
episodes of MSCC were treated with external beam RT in 34 patients with
metastatic colorectal cancer. The median total dose was 3000 cGy (18004750 cGy), and the daily fraction size was 300 cGy (151-400 cGy). All
patients were followed until death. RESULTS: Median overall survival for
the entire cohort was 4.1 months. Of 21 patients ambulatory before RT, 20
remained ambulatory after treatment, whereas only 2 of 9 patients who
were nonambulatory regained full ambulatory status. Patients with rectal
primary tumors had improved survival (median 7.9 months) compared with
those who had colon primary tumors (2.7 months) (P = 0.002). Patients who
received a total dose of more than 3000 cGy had a better survival (7
months) than those who received 3000 cGy or less (3.1 months) (P =
0.024). There was a trend for improved survival in patients fully
ambulatory at diagnosis (P = 0.056) and after RT (P = 0.07). Unlike other
primary sites in which approximately 70% of lesions are located in the
thoracic spine, the location of epidural metastasis in colorectal primary
tumors was most frequently in the lumbar spine (55% of lesions).
CONCLUSIONS: Prognostic features and outcomes for MSCC with primary
colorectal cancer are similar to those for other primary sites. There is
a suggestion that rectal primary tumors may be associated with an
improved outcome compared with colon primary tumors. Patients who
received more than 3000 cGy total dose had a longer survival than those
who received lower total doses.
<33>
Unique Identifier
11533573
Medline Identifier
21424417
Authors
Babic Z. Papa B. Sikirika-Bosnjakovic M. Prkacin I. MisigojDurakovic M. Katicic M.
Institution
University Clinic for Diabetes, Endocrinology and Metabolic Diseases
Vuk Vhrovac, Zagreb, Croatia.
Title
Occult gastrointestinal bleeding in rugby player.
Source
Journal of Sports Medicine & Physical Fitness. 41(3):399-402, 2001
Sep.
Abstract
BACKGROUND: Local ischemia and mechanical trauma to hollow abdominal
organs are quoted as a cause of gastrointestinal (GI) bleeding during and
after long distance running. There are no data on athletes from rugby and
other contact sports where mechanical trauma of the abdomen is frequent.
METHODS: Occult bleeding in the stool of Croatian national rugby team
players has been investigated during and after qualification match with
Italy for the World Cup 1999 on June 6th 1998 in Makarska, Croatia. One
player with positive test was followed and examined in detail after the
game. RESULTS: Among 11 Croatian players authors discovered one with a
history of GI symptoms and one with conversion of negative to positive
test for occult bleeding in stool after the match. The latter player had
no GI symptoms or diseases, took no medications, played only 20 minutes
in the match on forward position. Conversion has been found in the second
stool sample after game (24 to 48 hours after game). The athlete was
followed for 18 months. Persistent low values of hemoglobin, hematocrit
and serum iron were revealed, as well as expressed hemorrhoids without
signs of haemorrhage or inflammation. CONCLUSIONS: Lower incidence of GI
bleeding among rugby players than among long distance runners minimize
the importance of mechanical abdominal trauma in the etiology of GI
bleeding during sports activity. Hemorrhoids are not quoted as a cause of
GI bleeding after sport activity among athletes.
<34>
Unique Identifier
11421601
Medline Identifier
21316926
Authors
Clark JL.
Institution
Surgery Service, Department of Veterans Affairs, Minneapolis Veterans
Administration Medical Center, One Veterans Drive, Minneapolis, Minnesota
55417, USA.
Title
Ventral incisional hernia recurrence.
Source
Journal of Surgical Research. 99(1):33-9, 2001 Jul.
Abstract
During the period October 1993 to December 1996, 31 patients were
operated on by the author for primary or recurrent ventral incisional
hernia (VIH). Three patients were excluded from analysis because their
records were unavailable for review. The median age of the 28 remaining
patients at their initial procedure was 57.5 years (range, 37-78 years).
The repair was performed with interrupted O-Ethibond sutures in all but 3
cases where Prolene suture was used secondary to noniatrogenic
contamination or recurrent hernia. There were no unplanned enterotomies
in the entire series and prophylactic intravenous antibiotics were used
in all cases. The only significant complications were skin hyperemia
after five repairs in 3 patients who were treated empirically with
intravenous antibiotics, and 1 patient who had an antibiotic-associated
rash. There were no 30-day mortalities. Prolene mesh was used exclusively
in all repairs performed with mesh. Seven of these repairs (25%) were for
recurrent VIH. Three of these seven patients had previous mesh repairs.
Six of these seven patients who presented with recurrent VIH had a mesh
repair and four developed a recurrence. Five of seven were active
smokers, with one having severe obstructive lung disease. Four of seven
related significant occupational lifting. Of the 21 patients having
initial repair of VIH, mesh was used in 8 (38%). After a median follow-up
of 13 months, there were 2 recurrent hernias (25%). The remaining 13
patients had primary closure of their hernias. After median follow-up of
25 months, there were 5 recurrences (38%). A total of 34 VIH repairs were
performed on these 28 patients, of which 13 were for recurrent hernias.
Five of thirteen (38%) of the mesh repairs for recurrent VIH failed. The
median body mass index (BMI) for the 13 patients having primary repair
was 26.4, and that for all 21 cases having mesh repair was 28.8. Patients
with recurrent VIH frequently recur despite use of mesh, avoidance of
contamination, and consistent technique. No difference in BMI was
apparent in those who recurred. Continued smoking and occupational
lifting may be important risk factors for recurrent VIH. Copyright 2001
Academic Press.
<35>
Unique Identifier
10340079
Medline Identifier
99271438
Authors
Dabareiner RM. White NA.
Institution
Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional
College of Veterinary Medicine, Virginia Polytechnic Institute and State
University, Leesburg 22077, USA.
Title
Surgical repair of a diaphragmatic hernia in a racehorse.
Source
Journal of the American Veterinary Medical Association. 214(10):15178, 1496, 1999 May 15.
Abstract
A 9-year-old Thoroughbred was evaluated for clinical signs of acute
abdominal pain. During laparotomy, a rent in the diaphragm and herniation
of the small intestine into the thoracic cavity were detected. Because
edges of the rent were smooth and fibrous, which suggested the defect was
chronic, the abdomen was closed without repairing the rent. After
recurrence of clinical signs, a second laparotomy was performed, during
which the intestines were found to have reherniated. The diaphragmatic
rent was repaired, using a polypropylene mesh secured with stainless
steel staples. The horse recovered and subsequently returned to racing
and jumping. A diaphragmatic hernia should be suspected in horses that
have moderate to severe signs of abdominal pain for which a definitive
cause can not be identified. Thoracic ultrasonography or radiography can
be used to confirm the hernia. Diaphragmatic hernias in horses can be
successfully repaired using mesh implants secured with staples.
<36>
Unique Identifier
10319180
Medline Identifier
99252738
Authors
Zekas LJ. Ramirez S. Brown MP.
Institution
Department of Large Animal Clinical Sciences, College of Veterinary
Medicine, University of Florida, Gainesville 32610-0136, USA.
Title
Ablation of the nephrosplenic space for treatment of recurring left
dorsal displacement of the large colon in a racehorse.
Source
Journal of the American Veterinary Medical Association. 214(9):1361-3,
1335, 1999 May 1.
Abstract
Left dorsal displacement of the large colon was diagnosed in a 3-yearold Thoroughbred gelding. Conservative treatment that included lunging
after administration of phenylephrine and rolling while under general
anesthesia was not successful. The displaced segment of colon was reduced
surgically through a ventral midline incision, but displacement recurred
4 days after surgery. Ablation of the nephrosplenic space by suturing the
nephrosplenic ligament to the splenic capsule was performed through the
left flank. At followup 1 year after surgery, the horse had not had
further signs of colic and had returned to racing. Other methods to
prevent large colon displacement, including colon resection and colopexy,
are not recommended for athletic horses. Ablation of the nephrosplenic
space, however, may be efficacious.
<37>
Unique Identifier
9783640
Medline Identifier
98454961
Authors
Iuchtman M.
Title
Rarity of traumatic abdominal wall hernias. [letter; comment.].
Comments
Comment on: J Trauma. 1998 Mar;44(3):568 ; 9529196
Source
Journal of Trauma-Injury Infection & Critical Care. 45(4):853, 1998
Oct.
<38>
Unique Identifier
11791065
Medline Identifier
21650833
Authors
Chanson C. Hahnloser D. Nassiopoulos K. Petropoulos P.
Institution
Department of Surgery, Hopital Cantonal, Fribourg, Switzerland.
Title
Gastric and omental incarceration through an occult traumatic
diaphragmatic hernia in a scuba diver.
Source
Journal of Trauma-Injury Infection & Critical Care. 52(1):146-8, 2002
Jan.
<39>
Unique Identifier
9529196
Medline Identifier
98188045
Authors
Perez VM. McDonald AD. Ghani A. Bleacher JH.
Institution
Department of Surgery, Western Reserve Care System, Youngstown, Ohio,
USA.
Title
Handlebar hernia: a rare traumatic abdominal wall hernia. [see
comments.].
Comments
Comment in: J Trauma. 1998 Oct;45(4):853 ; 9783640
Source
Journal of Trauma-Injury Infection & Critical Care. 44(3):568, 1998
Mar.
<40>
Unique Identifier
11791070
Medline Identifier
21650838
Authors
Holmes JH 4th. Hall RA. Schaller RT Jr.
Institution
Department of General Surgery, Virginia Mason Medical Center, Seattle,
Washington 98111, USA. resjhh@vmmc.org
Title
Thoracic handlebar hernia: presentation and management.
Source
Journal of Trauma-Injury Infection & Critical Care. 52(1):165-6, 2002
Jan.
<41>
Unique Identifier
11438136
Medline Identifier
21332032
Authors
Basnyat B. Graham L. Lee SD. Lim Y.
Institution
Nepal International Clinic and Himalayan Rescue Association, Kathmandu,
Nepal. rishibas@wlink.com.np
Title
A language barrier, abdominal pain, and double vision.
Source
Lancet. 357(9273):2022, 2001 Jun 23.
<42>
Unique Identifier
9240020
Medline Identifier
97384216
Authors
Mechrefe A. Wexler B. Feller E.
Institution
George Washington University, USA.
Title
Sports anemia and gastrointestinal bleeding in endurance athletes.
[Review] [7 refs]
Source
Medicine & Health, Rhode Island. 80(7):216-8, 1997 Jul.
<43>
Unique Identifier
10694128
Medline Identifier
20155820
Authors
Morton DP. Callister R.
Institution
Discipline of Human Physiology, Faculty of Medicine and Health
Sciences, The University of Newcastle, Callaghan, NSW, Australia.
darren.morton@avondale.edu.au
Title
Characteristics and etiology of exercise-related transient abdominal
pain.
Source
Medicine & Science in Sports & Exercise. 32(2):432-8, 2000 Feb.
Abstract
PURPOSE AND METHODS: In order to investigate the characteristics of the
exercise-related transient abdominal pain (ETAP) commonly referred to as
"stitch," a questionnaire was administered to a total of 965 regular
sporting participants involved in six sports. RESULTS: The percentage of
respondents claiming to have experienced ETAP within the past year for
the respective sports were: running (69%, N = 439), swimming (75%, N =
103), cycling (32%, N = 76), aerobics (52%, N = 126), basketball (47%, N
= 121), and horse riding (62%, N = 100). ETAP appears to be most
prevalent in activities that involve repetitive torso movement, either
vertical translation or longitudinal rotation. ETAP appears to be a
single condition, common in its manifestation to most sufferers, and was
described by respondents as a well-localized pain (79%), mostly
experienced in the right or left lumbar regions of the abdomen (78%). The
sensation of ETAP may be related to the severity of pain with less
intense ETAP being described as cramping, aching, or pulling, and greater
severity ETAP as sharp or stabbing in nature. Fourteen percent of
respondents indicated that they experience shoulder tip pain (STP), which
being the diaphragmatic-referred site could suggest irritation of the
diaphragm. Respondents claiming to have experienced ETAP were more likely
to report STP (r = 0.14, P < 0.01). CONCLUSIONS: The findings of the
present study provide perspective on previously suggested etiologies of
ETAP, which include diaphragmatic ischemia and stress on the visceral
"ligaments," and form the basis for examining alternative etiologies such
as cramp of the musculature and irritation of the parietal peritoneum.
<44>
Unique Identifier
11071673
Medline Identifier
20486787
Authors
Becker KM. Moe CL. Southwick KL. MacCormack JN.
Institution
Epidemic Intelligence Service, Centers for Disease Control and
Prevention, Atlanta, USA. kbecker@osophs.dhhs.gov
Title
Transmission of Norwalk virus during football game.
Source
New England Journal of Medicine. 343(17):1223-7, 2000 Oct 26.
Abstract
BACKGROUND: During a college football game in Florida, diarrhea and
vomiting developed in many of the members of a North Carolina team. The
next day, similar symptoms developed in some of the players on the
opposing team. METHODS: We interviewed those who ate the five meals
served to the North Carolina team before the game and some of the players
on the opposing team who became ill. Patients with primary cases were
members or staff of the team who had vomiting or diarrhea at least 10
hours after but no more than 50 hours after eating a box lunch served the
day before the game. Patients with secondary cases had a later onset of
symptoms or had symptoms without having eaten the box lunch. Stool
samples were examined by electron microscopy and by a reversetranscription-polymerase-chain-reaction (RT-PCR) assay. RESULTS: The two
football teams shared no food or beverages and had no contact off the
playing field. Of five meals served to the North Carolina team before the
game, only the box lunch was associated with a significant risk of
illness (relative risk of illness, 4.1; 95 percent confidence interval,
1.6 to 10.0). The rate of attack among those who ate the box lunch was 62
percent. There were 11 secondary cases among the members and staff of the
North Carolina team and 11 such cases among the Florida players. All four
stool samples obtained from North Carolina patients were positive for
Norwalk-like virus on electron microscopy. All four samples as well as
one of two stool samples from players on the Florida team were positive
for a Norwalk-like virus of genogroup I on RT-PCR assay; the RT-PCR
products had identical sequences. CONCLUSIONS: This investigation
documents person-to-person transmission of Norwalk virus among players
during a football game. Persons with acute gastroenteritis should be
excluded from playing contact sports.
<45>
Unique Identifier
10777225
Medline Identifier
20237004
Authors
Brieseman M. Hill S. Holmes J. Giles S. Ball A.
Institution
Crown Public Health, Christchurch.
Title
A series of outbreaks of food poisoning?.
Source
New Zealand Medical Journal. 113(1104):54-6, 2000 Feb 25.
Abstract
A series of independently occurring episodes which were notified
individually as 'food poisoning' were, after investigation, linked to a
common source water supply.
<46>
Unique Identifier
11493828
Medline Identifier
21385750
Authors
Ramsook C.
Institution
Baylor College of Medicine, Texas Children's Hospital, Department of
Pediatrics, Section of Emergency Medicine, Houston, Texas, USA.
caramsoo@pol.net
Title
Traumatic appendicitis: fact or fiction?.
Source
Pediatric Emergency Care. 17(4):264-6, 2001 Aug.
<47>
Unique Identifier
10415303
Medline Identifier
99346372
Authors
Kubota A. Shono J. Yonekura T. Hoki M. Asano S. Hirooka S. Kosumi
T. Kato M. Oyanagi H.
Institution
Department of Surgery II, Kinki University School of Medicine, 377-2
Onohigashi, Osakasayama 589-8511, Japan.
Title
Handlebar hernia: case report and review of pediatric cases. [Review]
[15 refs]
Source
Pediatric Surgery International. 15(5-6):411-2, 1999 Jul.
Abstract
The authors describe a rare case of handlebar hernia in a 9-year-oldboy. All layers of his abdominal wall were disrupted by a fall on a
bicycle; however, his skin and intra-abdominal organs were completely
intact. Computed tomography demonstrated subcutaneous intestinal loops
protruding through the rent. Surgical repair was performed, and his
postoperative course was uneventful. [References: 15]
<48>
Unique Identifier
11455807
Medline Identifier
21349478
Authors
Karas JA. Nicol MP. Martinson N. Heubner R.
Institution
Karas, Isaacson and Associates, PO Box 14566, Hatfield, 0028 Pretoria.
Title
An outbreak of food poisoning among children attending an international
sports event in Johannesburg. [see comments.].
Comments
Comment in: S Afr Med J. 2001 May;91(5):402, 404 ; 11455802
Source
South African Medical Journal. 91(5):417-21, 2001 May.
Abstract
OBJECTIVES: To describe an outbreak of food poisoning at a major
international sports event in Johannesburg and to determine the likely
cause and source of the outbreak. DESIGN: A descriptive, case-control
study. SETTING: An international sports event in Johannesburg. METHODS: A
questionnaire survey of involved children was used to conduct a casecontrol study. Microbiological and chemical analysis of the implicated
food was undertaken. Site visits to the premises involved in food
preparation were conducted. RESULTS: A total of 578 children were
involved. Of the 361 children who returned questionnaires, 134 were
affected by an acute-onset emetic-type illness, while 53 children
developed diarrhoea. Consumption of fruit juice was associated with acute
illness, while diarrhoea was associated with the consumption of maizemeal porridge (pap) and chicken stew. Microbiological analysis revealed
high bacterial loads in samples of the fruit juice and the presence of
Shigella flexneri in the maize-meal porridge. Visits to the suppliers of
the implicated foods revealed several deficiencies in terms of food
hygiene precautions. CONCLUSION: The likely vehicles and causes of this
outbreak are
distribution
Furthermore,
outbreaks in
elucidated. Guidelines for monitoring the supply and
of food to future similar events should be established.
hospitals should have protocols in place to deal with such
a manner that facilitates epidemiological investigation.
<49>
Unique Identifier
9885094
Medline Identifier
99100832
Authors
Gil SM. Yazaki E. Evans DF.
Institution
St Bartholomew's, London, England.
Title
Aetiology of running-related gastrointestinal dysfunction. How far is
the finishing line?. [Review] [163 refs]
Source
Sports Medicine. 26(6):365-78, 1998 Dec.
Abstract
30 to 65% of long distance runners experience gastrointestinal (GI)
symptoms related to exercise. Several hypotheses have been postulated;
however, the aetiology and pathophysiology are far from clear. The
mechanical effect of running on the viscera must be involved in the
development of GI symptoms in this sport. Reduction of splanchnic blood
flow due to visceral vasoconstriction is another widely supported theory;
nevertheless, it does not explain many of the clinical findings.
Examination of the GI tract during exercise is a difficult task, and
measurements of both orocaecal and whole-gut transit time have shown
equivocal results. GI hormones, and especially prostaglandins, may be of
crucial importance for the production of symptoms. Intestinal absorption,
secretion and permeability may also be altered during exercise, provoking
intestinal dysfunction. Factors such as stress, diet, dehydration,
infections and other factors need to be analysed in order to present a
global view of the hypotheses regarding the aetiology of this common and
often overlooked problem. [References: 163]
<50>
Unique Identifier
11269552
Medline Identifier
21166061
Authors
Rosen M. Garcia-Ruiz A. Malm J. Mayes JT. Steiger E. Ponsky J.
Institution
Department of General Surgery, The Cleveland Clinic Foundation, Ohio
44195, USA.
Title
Laparoscopic hernia repair enhances early return of physical work
capacity.
Source
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 11(1):2833, 2001 Feb.
Abstract
Several researchers have documented less postoperative pain and a
quicker return to daily activities after laparoscopic herniorrhaphy.
However, little objective data that validates this hypothesis exists.
This study compares the rate of postoperative physical work capacity with
return to preoperative levels, which is measured by a standard treadmill
test in patients who underwent laparoscopic and conventional open hernia
repair. Patients completed a 6-minute walking test preoperatively and 1
week postoperatively using a nonmotorized treadmill. The distance walked
was recorded. If the distance that a patient achieved at 1 week was not
within 0.02 miles of the preoperative values of the patient, the patient
was asked to return at 1 month for repeat testing. Patients were enrolled
prospectively in this study from October 1997 to February 1999. Sixty-six
patients participated in the study (27 laparoscopic herniorrhaphies and
39 open herniorrhaphies were performed). There was no significant
difference in age, body mass index, or preoperative distance achieved
among the two groups. At 1 week, patients who underwent laparoscopic
repair demonstrated a mean increase of 18 meters from preoperative
distance (P = 0.07). In the open group, patients demonstrated a mean
decrease of 90 meters at 1 week (P = 0.001). The change in distance at 1
week between the laparoscopic and the open groups was statistically
significant (P = 0.001). However, at 1 month, there was no significant
difference among the two groups. Measured using treadmill walking,
laparoscopic hernia repair seems to offer an early advantage to open
repair in return-to-physical-work capacity.