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Biomedical subjects

A Tittobello

Publications and source records attributed to A Tittobello.

At least 55 records · Page 3Linked to original sources
PubMed1989

Deranged gastric mucus secretion in erosive prepyloric changes.

Gastric mucus secretion was quantitatively and qualitatively assessed in 44 patients with endoscopic diagnosis of erosive prepyloric changes (EPC) grade 2 or 3. A matched group of patients with normal endoscopic appearance was used as a control group. The total amount of mucus glycoproteins in fasting gastric juice was similar in EPC patients and in healthy controls. However, the viscous and protective properties of mucus, as assessed by the ratio of neutral to total mucoproteins ('mucoprotective index') was significantly (p less than 0.01) reduced in patients with macroscopic erosions (grade 3 EPC). Alterations of the gastric mucous coating may account for the passive intraluminal outflow of HCO3 previously reported in subjects with grade 3 EPC. Whether the impairment of the 'mucus-bicarbonate' barrier is a cause or a consequence of prepyloric erosions remains to be determined.

Adult↗
PubMed1989

Rioprostil and the gastric mucus-bicarbonate barrier.

The effects of a single oral dose of rioprostil, 150 micrograms, rioprostil, 300 micrograms, or placebo on gastric mucus and bicarbonate secretion were investigated in humans under basal conditions and during pentagastrin infusion. The study was carried out in healthy male volunteers according to a double-blind crossover design. Rioprostil, 300 micrograms, significantly stimulated basal mucus secretion and induced a significant increase in mucoprotein and bicarbonate output during pentagastrin infusion. The results suggest that rioprostil enhances the gastric mucus-bicarbonate barrier in man.

Adult↗
PubMed1989

Rioprostil in the treatment of duodenal erosions.

Thirty outpatients with erosions of the duodenal bulb unrelated to peptic ulcer were randomly allocated to an 8-week treatment regimen with either rioprostil, 200 micrograms b.d., or with sucralfate, 1 g t.i.d. At endoscopic control complete disappearance of duodenal erosions was found in 57.2% of rioprostil-treated patients and in 64.3% of patients treated with sucralfate. The difference was not statistically significant. The two drugs were shown to be significantly and equally effective in inducing relief of dyspeptic symptoms. No intestinal side effects were observed during treatment with rioprostil.

Adult↗
PubMed1989

Esophageal motility in cirrhotics with and without esophageal varices.

Esophageal manometry was performed in 45 cirrhotics with varices, in 15 cirrhotics without varices, and in 20 normal subjects, to define the effect of varices on esophageal motility. Cirrhotics with varices showed a decreased amplitude of motor waves in the lower half of the esophagus (p less than 0.01), an increased duration of primary peristaltic waves along the entire length of the esophagus (upper esophagus, p less than 0.05; lower esophagus, p less than 0.01), and an increased peak-to-peak speed of primary peristaltic waves (p less than 0.01). Resting lower esophageal sphincter pressure and duration of sphincter relaxation were similar in patients and controls. The above-mentioned abnormalities might be due to the mechanical effect of the presence of varices.

Adolescent↗
PubMed1989

Motor effects of locally administered pinaverium bromide in the sigmoid tract of patients with irritable bowel syndrome.

The effects of pinaverium bromide, a non-absorbable antispasmodic agent, administered locally, on sigmoid-rectal motility was investigated in 20 patients with irritable bowel syndrome. The influence of either pinaverium (10 subjects) or placebo (10 subjects) on a neostigmine-induced increase of sigmoid pressure was assessed and compared by means of computerized electromanometry. The drug was found to counteract significantly the motor effects of neostigmine, thus appearing to be an effective compound for the treatment of functional disorders of the colon.

Adult↗
PubMed1988

Cisapride versus placebo in reflux esophagitis. A multicenter double-blind trial.

In a 6 to 12-week double-blind trial, the effect of cisapride (10 mg q.i.d.) was compared with that of placebo in 63 patients with esophagitis confirmed by endoscopy and/or biopsy. In only one patient (3%) in the cisapride group but in 43% of the placebo patients (p = 0.001), symptoms had not improved after 6 weeks. Forty patients continued treatment until week 12. At that time, control endoscopy showed a significantly (p = 0.005) higher rate of healing (no erosions, ulcers, or bleeding mucosa) in the cisapride patients (63%) than in the placebo patients (12%). At week 12, only three of the 21 cisapride patients still had moderate reflux symptoms, whereas eight of the 19 placebo patients had moderate or severe symptoms (p less than 0.05). Cisapride patients also took significantly (p less than 0.001) less antacids during the trial. These results show that cisapride, 10 mg q.i.d., heals esophagitis lesions and greatly reduces associated symptoms. The treatment was well tolerated.

Adult↗
PubMed1987

Interdigestive motility pattern in subjects with duodenogastric bile reflux.

The role of antroduodenal motility in the pathogenesis of duodenogastric biliary reflux is widely accepted, but few and conflicting data are available on the possible motor abnormalities related to this phenomenon in the fed and in the fasting state. In an attempt to define the motility pattern of the antroduodenal region associated with bile reflux in the fasting state, 20 subjects with proven duodenogastric reflux and without disorders of the upper gastrointestinal tract have been studied, and the results have been compared with those observed in 6 control subjects without evidence of reflux. The interdigestive motility complex (IDMC) has been evaluated (mean duration of IDMC and frequency and site of onset of migrating motor complexes). In subjects with duodenogastric reflux a significant increase (p less than 0.01) in the mean duration of IDMCs (179 +/- 22.19 min) was observed, in comparison with controls (108.5 +/- 37 min). A considerable reduction in the frequency of migrating motor complexes (MMC) was also observed, while no differences in the site of onset and the propagation of MMCs and in the percentage of time recorded occupied by the single phases of IDMC were found. This evidence suggests a strict relationship between duodenogastric reflux and the occurrence of phase III of IDMC and supports the hypothesis that the IDMC abnormalities are the cause and not the consequence of biliary reflux. The reduced incidence of MMC may also account for the high incidence of chronic gastritis due to prolonged contact in the fasting state between the gastric mucosa and the duodenal content.

Adult↗
PubMed1987

Duodenogastric reflux: correlations among bile acid pattern, mucus secretion, and mucosal damage.

Forty-five patients with bile reflux at endoscopic examination, confirmed by titration of bile acids in gastric juice, were admitted to the study and divided into three groups in accordance with histologic results: normal findings, chronic superficial gastritis, and chronic atrophic gastritis. Bile acid pattern was determined in duodenal samples by high-performance liquid chromatography titration, and the mucoprotein content of gastric juice was assessed. The results of qualitative analysis of bile acid showed an increase of deoxycholic acid in patients with atrophic gastritis (p less than 0.05) in comparison with controls; determination of taurine and glycine conjugates showed an increase of taurodeoxycholic acid in patients with atrophic gastritis (p less than 0.01) compared with controls. The composition of mucus was altered only in patients with atrophic gastritis. Whether the increase in deoxycholic acid in biliary reflux is a factor in the development of chronic atrophic gastritis or is secondary to the increase of gastric pH, detectable in this condition, is still uncertain. However, the increase of deoxycholic acid and its taurine conjugates may be a factor that leads to persistence of mucosal lesions.

Adult↗
PubMed1987

Gastric cancer in chronic atrophic gastritis. Associated gastric ulcer adds no further risk.

Atrophic gastritis with intestinal metaplasia is generally considered a precancerous lesion. We followed 261 patients with chronic atrophic gastritis and intestinal metaplasia, with and without gastric ulcer, every 12 months for 9 +/- 2 years by means of endoscopic and histological examination. In the presence of dysplasia, however, studies were carried out every 6 months in moderate cases, or every 3 months in severe cases. Patients with gastric ulcer received medical therapy for 8 weeks; if healing did not occur, treatment was continued. Only subjects with healed ulcers were admitted to the follow-up. To date, 205 subjects have been included in the study. Over a 10-year period, 16 patients with recurrent gastric ulcer and 12 patients with cancer in situ or in an early stage, were subjected to surgery. One case of advanced cancer was observed. Cancer has been found in five of 95 cases of atrophic gastritis with gastric ulcer (5.2%), and in 7 of 166 cases of atrophic gastritis without gastric ulcer (4.2%). The difference was not statistically significant. Our results confirm that gastric ulcer per se is not a high-risk condition, but it must be considered as an epiphenomenon on a background of epithelial atrophy.

Adenocarcinoma↗
PubMed1986

Gastric effects of a prostaglandin E1-derivate (rioprostil) on acid, alkaline, and mucus secretion.

In a double-blind crossover study, the gastric effects of a single oral dose of rioprostil (150 and 300 micrograms) or placebo were compared in basal conditions and during a 120-minute pentagastrin infusion. A slight decrease in basal acid output and a nonsignificant rise in basal bicarbonate secretion were observed with the 300-micrograms dose. Pentagastrin-stimulated acid secretion was reduced by the prostaglandin derivate, especially with the 300-micrograms dose. Compared with placebo, 300 micrograms of rioprostil significantly stimulated basal mucoprotein secretion and bicarbonate and mucus output during pentagastrin infusion. The results suggest that 300 micrograms of rioprostil exerts both a moderate antisecretory activity and a strengthening effect on the gastric mucus-bicarbonate barrier.

Adult↗
PubMed1985

[Effect of tiropramide chlorhydrate on intestinal transit time in patients with irritable colon syndrome].

The effect of tiropramide hydrochloride--a new spasmolytic drug with calmodulin-independent activity--in correcting alterations of intestinal transit, has been investigated in 40 IBS patients (20 with accelerated and 20 with delayed transit time). Intestinal transit has been evaluated by means of radioopaque markers. Tiropramide hydrochloride, at a dose of 100 mg t.i.d. for 4 weeks, was found significantly more effective than placebo both in normalizing intestinal transit time and in inducing symptomatic relief.

Adult↗
PubMed1985

Effect of nifedipine on gastric acid secretion and gastrin release in healthy man.

Nifedipine, a calcium-channel antagonist widely used in cardiovascular disease, has recently been reported to be effective in the treatment of oesophageal motor disorders. The effect of a single therapeutic dose of nifedipine (20 mg p.o.) has been evaluated on basal and submaximal pentagastrin-stimulated gastric secretion and meal-stimulated gastrin release in healthy man. In comparison with placebo, nifedipine significantly decreased both basal and stimulated gastric acidity and juice volume, whereas only a slight but insignificant reduction in meal-stimulated gastrin levels was observed after drug administration. The results are in agreement with previous reports that calcium is involved in stimulus-secretion coupling in the human parietal cell. They do not confirm the effect of calcium on G-cells, although it is likely that doses of nifedipine higher than those commonly used might be effective in the reduction of gastrin secretion.

Adult↗
PubMed1985

Pirenzepine in erosive duodenitis. A controlled clinical trial versus ranitidine.

Fifty-five outpatients with chronic duodenal erosions and no previous ulcer history were treated, in a double-blind fashion, with either pirenzepine (50 mg twice daily) or ranitidine (150 mg twice daily) for 6 weeks. The drugs were equally effective in inducing symptomatic relief. At endoscopic control, 70.4% of subjects in the pirenzepine group and 39.3% of ranitidine-treated patients showed complete healing (p less than 0.05). The results suggest that acid secretion is not an important factor in the pathogenesis of erosive duodenitis and that other mechanisms (such as impaired mucosal blood flow) must be considered.

Adult↗
PubMed1985

Effect of sulglycotide on gastric bicarbonate secretion in humans.

The effect of sulglycotide, a cytoprotective agent with a healing effect on ulcers, on gastric bicarbonate secretion in humans was evaluated. Fifteen healthy volunteers were treated with sulglycotide 400 mg t.i.d. for 10 days. Before and after treatment the bicarbonate content of basal gastric juice was determined by Feldman and Barnett's method. Sulglycotide was found to increase significantly (p less than 0.0001) basal HCO3- production from the human stomach, thus strengthening the gastric mucosal defences. It was concluded that the cytoprotective and therapeutic properties of the drug are partially related to stimulation of gastric alkaline secretion.

Adult↗
PubMed1985

Comparison of ranitidine, domperidone maleate and ranitidine + domperidone maleate in the short-term treatment of reflux oesophagitis.

In the treatment of reflux oesophagitis, either drugs preventing regurgitation of gastric juice in the lower oesophagus or pharmacological agents increasing the pH of the refluxing material are employed. In the present study 45 outpatients with reflux oesophagitis were randomly treated with either ranitidine (150 mg b.i.d.) or domperidone maleate (20 mg t.i.d.) or both drugs for six weeks. Before and after treatment the severity of dyspeptic symptoms and the grade of endoscopic and histological changes were assessed. The three therapeutic regimens were significantly and equally effective in inducing symptomatic relief and promoting endoscopic and histological disappearance or improvement of oesophagitis. The combined use of ranitidine and domperidone maleate failed to show any additional benefit compared with treatment with either drug alone.

Clinical Trials as Topic↗
PubMed1984

Early detection of pancreatic lesions in chronic alcoholism: diagnostic accuracy of ERP.

In order to detect early pancreatic changes in chronic alcoholism, we reviewed pancreatograms (ERP) in 35 patients with alcoholic chronic liver disease who had no clinical evidence of pancreatitis. The patients were grouped by the length of history of alcohol intake (group 1: 5-15 years; group 2: more than 15 years), and on the basis of daily alcohol intake (group 1: 100-150 g/day; group 2: 150-200 g/day; group 3: more than 200 g/day). Pancreatic changes were present at ERP in 48.6% of patients, suggesting mild pancreatitis in 15 patients and advanced pancreatitis in two. Pancreatic lesions were significantly more frequent (p less than 0.01) in those who took more than 200 g of alcohol each day. There was no correlation with the length of history of alcoholism or with hepatic lesions. Our data confirm that asymptomatic pancreatitis is frequent in chronic alcoholism and that ERP can detect pancreatic lesions not otherwise demonstrable.

Adult↗
PubMed1984

Lack of effect of domperidone on gastrin release: evidence for a peripheral activity of the drug.

The effect of intravenous administration of domperidone, a dopamine receptor antagonist with peripheral activity, on basal and submaximal pentagastrin-stimulated gastric acid secretion and gastrin release has been evaluated in healthy volunteers. No significant changes were observed in the parameters studied. The lack of effect on gastrin release appears to confirm that domperidone is unable to penetrate the blood brain barrier in appreciable amounts in adults.

Adult↗