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Biomedical subjects

A Berstad

Publications and source records attributed to A Berstad.

At least 109 records · Page 6Linked to original sources
PubMed1994

Phospholipase A2 activity in gastric juice from patients with active and H. pylori-eradicated healed duodenal ulcer.

BACKGROUND: Despite the close association between gastric Helicobacter pylori infection and duodenal ulcer, little is known about how this organism may promote mucosal damage. A possibility might be that it produces, or induces the host to release, phospholipases that metabolize the protective layer of phospholipids. METHODS: Aimed at determination of phospholipase A2 activity and the concentration of choline-containing phospholipids in gastric juice, aspirates were collected during gastroscopy in 38 consecutive referrals with either active (n = 19) or H. pylori-eradicated healed duodenal ulcer (n = 19). RESULTS: Gastric juice phospholipase A2 activity was 3.1 times higher in active than in healed duodenal ulcers (P = 0.03). Concurrently, the concentration of choline-containing phospholipids in the group with active ulcers was less than half compared with the healed group (P = 0.02). CONCLUSION: The results indicate that phospholipase A2 activity and the concentration of choline-containing phospholipids in gastric juice are related to H. pylori status and duodenal ulcer disease.

Adult↗
PubMed1994

Effect of glyceryl trinitrate on antral motility and symptoms in patients with functional dyspepsia.

Nitric oxide (NO) is considered to be an important physiologic non-adrenergic, non-cholinergic vagal transmitter in the neural regulation of gastric adaptive relaxation, which accommodates the gastric fundus to ingested food. Ten consecutive patients with functional dyspepsia (FD) and erosive prepyloric changes were studied twice on separate days, once without drug administration and once after intake of one tablet of glyceryl trinitrate (GTN), 2.6 mg, 2 h before ingestion of 500 ml meat soup. Width of antral area, amplitude (maximal area reduction as fraction of relaxed area), and frequency of antral contractions were measured ultrasonographically in standardized sections. Postprandial abdominal discomfort was scored. Without GTN, postprandial antral area and symptom scores were positively correlated (r = 0.64, p = 0.05). After administration of GTN, antral area both fasting and 10 min postprandially was reduced (p = 0.02 and p = 0.01, respectively), whereas amplitude and motility index of antral contractions tended to increase (p = 0.07 and p = 0.09, respectively). Abdominal discomfort was not significantly reduced by GTN (p = 0.13). The results suggest a relationship between postprandial antral distension and discomfort. Moreover, GTN (by generation of NO) reduced abnormal antral filling in patients with FD.

Adult↗
PubMed1994

Helicobacter pylori in functional dyspepsia and normal controls.

BACKGROUND: The aim of this study was to examine whether Helicobacter pylori status can identify a specific subset of patients with functional dyspepsia (FD) and erosive prepyloric changes (EPC). METHODS: Anamnestic, somatic, and psychologic data were collected from 87 patients with functional dyspepsia and 77 normal control persons. Presence of H. pylori infection was assessed by the 14C-urea breath test. RESULTS: H. pylori infection increased with age. Thirty-four per cent of the patients were H. pylori-positive, compared with 36% of the control persons. The patients had higher scores than the normal control persons on psychologic measures regardless of H. pylori status. Of 27 variables analyzed, age was the only factor that discriminated between H. pylori-positive and -negative patients. CONCLUSIONS: For most patients with FD and EPC the presence of H. pylori infection is probably a consequence of age, and it does not seem to help us in the search for factors that can identify a subset of patients within our group of FD patients.

Adolescent↗
PubMed1994

Psychosocial Adjustment to Illness Scale (PAIS-SR) in a Norwegian material of patients with functional dyspepsia, duodenal ulcer, and urinary bladder dysfunction. Clinical validation of the instrument.

BACKGROUND: There is an increasing interest in the psychosocial impact of a disease, but few instruments available to measure it. METHODS: The internal consistency and construct validity of the Norwegian translation of the Psychosocial Adjustment to Illness Scale (PAIS-SR) was examined in a total of 557 patients. RESULTS: The seven dimensions of the psychosocial adjustment to medical illness from the original test were represented in the Norwegian translation. Psychologic distress, social environment, and vocational environment explained most of the variance. The instrument had high internal consistency with Cronbach's alpha coefficients of > 0.75 on six of seven subscales. The PAIS-SR differentiated between groups of patients with urologic and upper gastrointestinal disease and seemed to give meaningful and useful clinical data. Patients with functional dyspepsia (n = 97) had higher score on psychologic distress than the other groups, whereas patients with duodenal ulcer (n = 97) were significantly less affected in their social life than the other patients. CONCLUSIONS: The Norwegian translation of the PAIS-SR had high internal consistency, acceptable construct validity, and good discriminating validity.

Adolescent↗
PubMed1994

Ultrasonographic assessment of fasting liquid content in the human stomach.

BACKGROUND: Disturbed antroduodenal motility plays an important role in the pathophysiology of functional dyspepsia (FD). Such motility disturbances can be investigated by transcutaneous ultrasound. When it is measured in a standardized section, patients with FD have on an average significantly larger antral area than healthy controls. METHODS: In this study we investigated the relationship between the antral area measured by ultrasound and the amount of fasting gastric content quantitated by aspiration through the gastroscope in 30 patients. In five healthy controls we measured the increment of the antral area after ingestion of graded volumes of water. All recordings were made in interdigestive phase I. RESULTS: Measurements of the antral area were highly reproducible, with small variations within an hour and from day to day. There was a highly significant correlation between ultrasonographically measured antral area and amount of fasting gastric juice and between increment of antral area and amounts of ingested water. CONCLUSIONS: The ultrasonographically measured antral area during fasting is highly reproducible. Enlarged fasting antral area reflects increased volume of gastric juice.

Adolescent↗
PubMed1994

Quality of life and relapse of duodenal ulcer before and after eradication of Helicobacter pylori.

BACKGROUND: The aim of the study was to compare relapse rates and quality of life before and after eradication of Helicobacter pylori in a group of patients with documented recurrent duodenal ulcer disease. METHODS: Seventy-four patients with three endoscopically verified duodenal ulcers during the past 2 years received triple treatment consisting of bismuth subnitrate, oxytetracycline, and metronidazole for 14 days. Quality of life was measured with the Psychosocial Adjustment to Illness Scale (PAIS-SR) and H. pylori status with the 14C-urea breath test. RESULTS: After triple treatment H. pylori was eradicated in 96%, and the ulcer was healed in all. Ulcer relapse was reduced from 100% before to 1.4% during a mean observation time of 111 weeks. The H. pylori reinfection rate was 2.4% during the 1st year. The patients were more satisfied with the health care system and had better sexual relationship and less psychologic distress 1 year after eradication of H. pylori than before. CONCLUSIONS: For patients with recurrent duodenal ulcer, eradication of H. pylori with triple treatment leads to a significantly reduced ulcer relapse rate and improved quality of life.

Adolescent↗
PubMed1994

Helicobacter pylori eradication with bismuth subnitrate, oxytetracycline and metronidazole in patients with peptic ulcer disease.

A total of 152 patients with recurrent peptic ulcer disease were treated with bismuth subnitrate, oxytetracycline and metronidazole. The 51 patients in Group 1 were included following a study of the effect of cognitive psychotherapy on the recurrence rate after curative treatment for duodenal ulcer (DU). Group 2 comprised 101 consecutive patients referred to us with recurrent peptic ulcer. Their Helicobacter pylori (Hp) status was assessed before, and 4 weeks after, discontinuation of treatment, using the 14C-urea breath test. The primary aim of the study was to determine the effect of the triple treatment regimen on Hp eradication. All but two patients were Hp-positive prior to treatment. Four weeks after termination of treatment, Hp was found to have been eradicated in 50 out of 51 patients (98%) in Group 1, and in 86 out of 97 patients (89%) in Group 2. The respective ulcer healing rates for the two groups were 100% and 95%. Fifty percent of the patients noted moderate to severe adverse effects, mainly nausea and diarrhea, but only 5 patients discontinued treatment prematurely. The results indicate that virtually all patients with recurrent peptic ulcer disease have gastric Hp infection, and that the present triple treatment is highly effective in terms of both Hp eradication and ulcer healing.

Adult↗
PubMed1993

Lansoprazole in the treatment of reflux oesophagitis: a survey of clinical studies.

The newly developed proton pump inhibitor lansoprazole has been compared to placebo, ranitidine and with omeprazole in a number of clinical studies in patients with reflux oesophagitis. In three comparative studies against ranitidine, lansoprazole was found to be superior in terms of healing rates and symptom relief. In two studies against omeprazole, no significant difference was found in healing rates, while a Scandinavian study demonstrated more prompt relief from heartburn. Further studies are presently being conducted to evaluate the potential of lansoprazole in long-term treatment of reflux oesophagitis. It is concluded that lansoprazole is a safe, effective therapy for reflux oesophagitis, superior to ranitidine and comparable with omeprazole.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1993

Lansoprazole versus omeprazole in short-term treatment of reflux oesophagitis. Results of a Scandinavian multicentre trial.

To evaluate the therapeutic potential of the newly developed proton pump inhibitor lansoprazole in patients with reflux oesophagitis, we performed a double-blind randomized clinical trial comparing 20 mg omeprazole and 30 mg lansoprazole, involving 229 patients at 9 Scandinavian hospitals. The treatment period was 4 or 8 weeks, and main efficacy variables were healing of endoscopic changes, relief of reflux symptoms, and occurrence of adverse events. No significant difference in terms of healing was found, either after 4 or after 8 weeks' treatment. Patients receiving lansoprazole experienced a greater improvement in heartburn after 4 weeks (p = 0.03), and there was a similar trend for acid regurgitation. Lansoprazole was found to be an effective and safe alternative to omeprazole in short-term treatment of moderate reflux oesophagitis.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1993

Non-ulcer dyspepsia and gastritis--clinical aspects.

Although patients with non-ulcer dyspepsia (NUD) and peptic ulcer disease present similar symptoms, the two diseases are pathophysiologically completely different and should be treated accordingly. The diagnosis of NUD is still based on negative criteria, i.e., organic diseases must be excluded. The majority of the patients with NUD have a functional disorder possibly as a consequence of psychological stress which, by activating processes within the central nervous system, may evoke a sequence of reactions; By suppressing the vagal tone, fundic adaptation to ingested food may be impaired and the gastric antrum abnormally filled. The latter may contribute to largely unrecognized cause of epigastric discomfort. Increased responsiveness or hypersensitivity to visceral (gastric distention) and psychological (mental stress) stimuli may constitute important factors contributing to perception of discomfort, possibly as abnormal perception of normal events. The treatment of such a complex condition is difficult and may not be solved by medical intervention solely. Patients presenting with dyspepsia of unknown origin, should primarily be treated with antacids. Treatment with prokinetics (cisapride) is rational and worth trying. Antacids and H2-receptor antagonists may help in NUD patients with acid reflux. In patients with Helicobacter pylori-induced gastritis Al-Mg-antacids suppress, but alone do not eradicate the bacteria. Antacids in combination with oxytetracycline and metronidazole eradicate H. pylori in about one half of the infected patients.

Dyspepsia↗
PubMed1993

Increased fecal eosinophil cationic protein in inflammatory bowel disease.

Eosinophil cationic protein (ECP) is a cytotoxic substance released by eosinophilic granulocytes. Serum and body-fluid levels may be elevated in some allergic and inflammatory conditions characterized by heavy infiltration of eosinophils. ECP has not previously been measured in feces. Because pronounced infiltration with eosinophils is often seen in ulcerative colitis, we examined fecal excretion of ECP in 29 patients with active inflammatory bowel disease (IBD) and in 10 healthy persons. Mean fecal ECP levels were more than 14 times higher in the patients than in the healthy persons (p < 0.001). Fecal ECP was similarly elevated in ulcerative colitis and Crohn's disease. During storage, ECP in feces was relatively stable. Steroid treatment may suppress fecal ECP excretion. The possible value of fecal ECP as an IBD activity parameter warrants further studies. ECP may also be involved in the pathogenesis of IBD.

Adult↗
PubMed1992

[Treatment of stomach ulcer with bismuth subnitrate, oxytetracycline and metronidazole].

60 patients with recurrent duodenal ulcers were treated with bismuth subnitrate, oxytetracycline and metronidazole. Helicobacter pylori status was assessed before and after treatment by means of the 14C-urea breath test. All patients were helicobacter positive before treatment. Four weeks after cessation of therapy H pylori had been eradicated in 57 out of 60 patients (95%). The ulcer healing rate was 100% after six weeks. 43% of the patients complained of moderate to severe side effects, mainly nausea and diarrhoea, but no patients discontinued the treatment prematurely. The study indicates that nearly all patients with recurrent duodenal ulcer are infected with H pylori, and that the present triple treatment regimen is very effective both in eradicating H pylori and in healing the ulcer.

Adult↗
PubMed1992

[Diagnosis of Helicobacter pylori infection. Rapid urease test, microscopy of smears and culture from ventricular biopsy compared with the 14C-urea breath test].

By employing the 14C-urea breath test as the reference method we determined the specificity and sensitivity of three bioptic methods for diagnosis of Helicobacter pylori infection in 103 subjects. All biopsy specimens were obtained from the gastric antrum. For culture the specificity was 100%. Its applicability was reduced, however, by a low sensitivity (73.8%) and a delay of several days before the final result was available. Microscopy of Loeffler-stained biopsy smears yielded a specificity of 100% and a sensitivity of 92.9%, but the method was regarded time-consuming. The rapid urease test yielded a specificity of 98.4% and a sensitivity of 85.7%. Being quick, simple and inexpensive the rapid urease test is well suited for routine use in gastroscopy.

Bacteriological Techniques↗
PubMed1992

[Functional dyspepsia--a stress disease].

Because non-ulcer dyspepsia is associated with stress and motility disturbances it is now called functional dyspepsia. Compared with healthy persons, patients with functional dyspepsia are characterized by poor vagal tone, wider gastric antrum both fasting and postprandially, lack of stress-related repression of antral motility and meal-induced dyspeptic symptoms. Postprandial discomfort is related to antral distension. Poor vagal tone may cause antral distension and dysmotility as well as symptoms in these patients. Treatment programmes or drugs which improve vagal tone may be beneficial.

Dyspepsia↗
PubMed1992

Prevention of venous thromboembolism after surgery: a review of enoxaparin.

This review discusses the problem of deep vein thrombosis (DVT) after operation and identifies three levels of risk of DVT: low (less than 10 per cent), moderate (10-40 per cent) and high (40-80 per cent). Special emphasis is placed on the most recent prophylactic treatment, low molecular weight heparins (LMWHs), particularly enoxaparin. Several LMWHs are now available, but they differ slightly and each must be evaluated on its own merits. In general, however, LMWHs are both effective and safe in those patients at moderate or high risk of DVT. Thromboprophylaxis is cost effective when analysed using health-economic methodology.

Adult↗
PubMed1992

Comparison of low-dose antacids, cimetidine, and placebo on 24-hour intragastric acidity in healthy volunteers.

Low-dose aluminium (Al) antacids are effective in promoting ulcer healing and symptomatic relief in peptic ulcer patients, although the effect on intragastric acidity is very weak. In this randomized, double-blind study, 24-hr intragastric acidity was compared in 11 healthy volunteers, treated with a low-dose Al antacid regimen (1 tablet four times a day), cimetidine (800 mg at bedtime) and placebo, using the double-dummy technique. Standardized meals were given at 8 AM, noon, and 5 PM. Medication was given 1 hr after meals and at bedtime. Intragastric acidity was recorded with a nasogastric monocrystant antimony pH catheter, connected to an ambulatory digital data recorder. No significant difference in intragastric acidity was observed between antacid and placebo treatment. Treatment with cimetidine reduced circadian and nocturnal (but not diurnal) intragastric acidity significantly, as compared to both placebo and antacid treatment. The results support the hypothesis that Al antacids promote peptic ulcer healing by other mechanisms than acid neutralization.

Adult↗