By Alissa J. Walsh, Otto C. Buchel, Jane Collier, Simon P.L. Travis
Established round the middle curriculum for expert trainees in gastroenterology and hepatology, this e-book comprises 50 well-structured, peer-reviewed instances collected from the Oxford Hospitals, comprehensively masking some of the issues of the gastrointestinal system.
Each case contains a quick medical historical past and proper exam findings, info of investigations together with examples of clinical imaging, by way of questions about differential prognosis and administration and specified solutions and dialogue. The textual content is complemented via various black and white illustrations, together with radiographic photographs, and 24 color photos. The question-and-answer layout is designed to augment the reader's diagnostic skill and medical figuring out.
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Extra resources for Oxford Case Histories in Gastroentrology and Hepatology (Oxford Case Histories)
S113–S123. Bacon BR, Britton RS (2008). Clinical penetrance of hereditary hemochromatosis. (Editorial). N Engl J Med; 358: 291–2. CASE 7 Case 7 A 40-year-old HIV-positive male theatre critic presented to the outpatient department with a 10-week history of watery diarrhoea associated with a 7kg loss of weight. He had been diagnosed with HIV 2 years earlier after he developed two AIDS-defining illnesses (Pneumocystis jiroveci pneumonia and cytomegalovirus retinitis). His current medications were zidovudine, lamivudine, and saquinavir.
Endoscopic therapy reduces variceal wall tension by reducing variceal size until obliteration, and by increasing the thickness of the vascular wall. Variceal banding has proved more effective and safer than sclerotherapy (with ethanolamine) and is currently the endoscopic treatment of choice for oesophageal varices. Nevertheless, the choice is also influenced by the availability of equipment and expertise. Variceal obturation with tissue adhesives such as cyanoacrylate or with thrombin are generally limited to the treatment of gastric varices.
The incomplete penetrance of haemochromatosis in patients who are homozygous for C282Y is illustrated by a 50–75% prevalence of biochemical expression (increased ferritin and transferrin saturation), a 25% prevalence of nonspecific asthenia or arthropathy, and <10% prevalence of severe organ damage with cirrhosis, hepatocellular carcinoma, diabetes, or cardiomyopathy. From another perspective, approximately 20% of men and 40% of women who are homozygous for C282Y have a normal serum ferritin. One clear influence on clinical expression of the disease is that of female gender.