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Biomedical subjects

A Berstad

Publications and source records attributed to A Berstad.

283 records · Page 16Linked to original sources
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Peptic ulcer disease in south Ethiopia is strongly associated with Helicobacter pylori.

Helicobacter pylori infection was detected in 93% of 174 patients with a peptic ulcer compared with 63% of 116 patients with normal findings (chi 2 = 37.3; P < 0.001) in a cohort of 834 consecutive patients examined by gastroscopy in Yirga Alem Hospital in south Ethiopia. Fourteen patients were given 14 days' treatment with metronidazole 500 mg t.i.d., doxycycline 100 mg b.i.d. and bismuth subnitrate mixture 150 mg q.i.d. Of 10 patients who returned for follow-up, only 2 patients were free from H. pylori and cured. Nineteen strains of H. pylori from 19 consecutive patients in the same hospital were tested for resistance in vitro against metronidazole, doxycycline and ampicillin. All but 1 were highly resistant to metronidazole; 2 were fully and 14 intermediate resistant against doxycycline. All strains were fully sensitive in vitro to ampicillin. Thus, peptic ulcer was strongly associated with H. pylori in south Ethiopia, but eradication of the infection was hampered by antibiotic resistance.

Anti-Bacterial Agents↗
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Low vagal tone and antral dysmotility in patients with functional dyspepsia.

Effects of acute mental stress on gastric antral motility were investigated in 23 healthy persons and 25 patients with functional dyspepsia (FD). Real-time ultrasonography of gastric antrum was recorded, after ingestion of 500 ml meat soup, during a 4-min resting period, 2.5 min of mental stress, and a 4-min recovery period. Amplitude of antral contractions was scored as a fraction of relaxed area. Motility-index was calculated as the amplitude multiplied by frequency. Measurement of skin conductance reflected sympathetic tone, and respiratory sinus arrhythmia (RSA) was calculated to index vagal tone. Antral motility was reduced by mental stress in the healthy persons, but not in FD patients. Group differences were significant for amplitude (p < 0.002) and motility-index scores (p < 0.02). Sympathetic tone increased during stress in both groups. Vagal tone was lower in the FD patients than in the healthy controls (p < 0.001). The lack of stress-related reduction of motility among patients with FD may, therefore, be a consequence of poor vagal tone.

Adolescent↗
PubMedDate not supplied

Low vagal activity as mediating mechanism for the relationship between personality factors and gastric symptoms in functional dyspepsia.

Low vagal tone may represent a mediating mechanism for relationships between personality and symptoms of functional dyspepsia (FD) through a mechanism of antral hypomotility. Twenty-one patients with FD and seventeen healthy controls completed a series of personality tests before vagal and sympathetic activity, antral motility, and abdominal symptoms were assessed in response to a laboratory task. Functional dyspepsia patients had lower scores on vagal tone (p = .054) and motility index (p = .011) in addition to the expected higher scores on epigastric discomfort (p = .002). Psychological factors explained a substantial amount of the variance in vagal activity, antral motility, and reported symptoms. Symptoms were predicted by trait anxiety (STAI-TR), depression (BDI), and neuroticism (EPQ-N). Poor vagal tone was related to neuroticism (EPQ-N). Poor motility was best explained by task-related state dysphoria (SACL-STR).

Adolescent↗
PubMedDate not supplied

Effect of short-term cognitive psychotherapy on recurrence of duodenal ulcer: a prospective randomized trial.

The aim of this prospective, randomized trial was to assess whether short-term cognitive psychotherapy (10 sessions during 4 months) could reduce the 1-year recurrence rate of duodenal ulcer. One group received psychotherapy; one group was a control group. One hundred patients, aged 17 to 64 years, with duodenal ulcer were selected from March 1989 to May 1991. The main outcome measure was relapse of duodenal ulcer, which was verified by endoscopy. When psychotherapy started after cessation of antiulcer medication, the relapse-free time was significantly shorter in the therapy group than in the controls. When the protocol was modified so that psychotherapy and antiulcer medication were given concomitantly, there was no significant difference in recurrence rate between the groups at 1-year follow-up (84% in the therapy group and 92% in the control group). Symptoms of upper abdominal discomfort/pain, measured every second month, decreased significantly in the therapy group compared to the control group. Psychotherapy led to less neuroticism (Eysenck Personality Questionnaire) and less trait anxiety (Spielberger Trait Anxiety Scale) compared to controls at 4 months. At the 12-month follow-up, most of this gain was lost, but the psychotherapy group had lower scores on "concern about disapproval" on the Sociotropy-Autonomy Scale than the control group. There is no beneficial effect of short-term cognitive psychotherapy on the 1-year recurrence rate of duodenal ulcer.

Adaptation, Psychological↗
PubMedDate not supplied

Absorption of bismuth from two bismuth compounds before and after healing of peptic ulcers.

BACKGROUND/AIMS: Previous reports state that there is absorption of bismuth through active peptic ulcers. It was therefore of interest to investigate the extent of absorption in patients at the ulcer and post-ulcer stages. METHODOLOGY: Twenty H. pylori-positive patients with gastroscopically verified gastric or duodenal ulcers were randomly allocated to ingest 3000 mg bismuth subnitrate (BSN) (10 patients) or 480 mg colloidal bismuth subcitrate (CBS) (10 patients). Bismuth serum concentration in 12 samples drawn during the first 4 hours after drug intake was analyzed and the area under the curve (Bi-AUC) was calculated. Anti-H. pylori therapy with amoxicillin and lanzoprazole eradicated H. pylori in 10 patients and healed the ulcers in all patients 4 weeks after therapy ended, then the bismuth absorption test was repeated. RESULTS: There was no significant difference between ulcer- and post-ulcer Bi-AUC for patients receiving BSN or for patients receiving CBS. On a molar basis, CBS gave a 17.4-fold greater absorption of bismuth compared to BSN. CONCLUSIONS: The presence of an active ulcer does not significantly influence the absorption of bismuth from CBS or BSN.

Administration, Oral↗
PubMedDate not supplied

Effects of synthetic secretin on gastric secretion in man.

Five healthy subjects received on one occasion 2 mug/kg-hour of pentagastrin alone and on another occasion in combination with synthetic secretin (Schwarz/Mann) in the dose of 2 U/kg-hour. The gastric and duodenal contents were collected continuously through a gastroduodenal Lagerlöf tube. Polyethylene glycol and 57Co labelled vitamin B12 were used as non absorbable markers in the duodenum and in the stomach, respectively. In each subject synthetic secretin inhibited acid (mean inhibition 17 percent) and stimulated pepsin secretin (mean stimulation 49 percent). The findings indicate that these actions are properties of secretin itself.

Adult↗
PubMedDate not supplied

Follow-up on 242 patients with peptic ulcer disease one year after eradication of Helicobacter pylori infection.

BACKGROUND/AIMS: From Dec. 1990 to Jan. 1993 we treated 306 patients with chronic peptic ulcer disease and gastric Helicobacter pylori infection with one of three triple therapy regimens comprising bismuth subnitrate suspension (B) 15 mg/ml, oxytetracycline (OT), and metronidazole (M). METHODS: Treatment I (101 patients): B 5 ml, OT 500 mg, and M 200 mg, all q.i.d. for 14 days. Treatment II (60 patients): B 10 ml and OT 750 mg q.i.d., M 400 mg t.i.d. for 7 days. Treatment III (145 patients): B 10 ml and OT 500 mg q.i.d., M 400 mg t.i.d. for 10 days. Gastroscopy and 14C-urea breath test were performed 4 weeks and 1 year after cessation of therapy. RESULTS: According to the urea breath test, H pylori eradication rates at 4 weeks were 87.9%, 81.9%, and 95.0% for Treatment I, II and III, respectively. At one year, 4 out of 242 patients, who were H pylori negative at 4 weeks, had become H pylori positive, i.e., H pylori reinfection rate 1.7%, 95% CI 0.5-4.2%. Only one of these "reinfected" patients had ulcer recurrence. Another patient had duodenal ulcer recurrence shortly after cessation of treatment in spite of being H pylori eradicated, i.e., ulcer recurrence rate 0.8%, 95% CI 0.1-3.0%. CONCLUSIONS: During the first year after H pylori eradication by triple therapy, recurrence rates of H pylori infection and peptic ulcer are very low (below 4.2% and 3.0%, respectively).

Adult↗