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Biomedical subjects

G Dotevall

Publications and source records attributed to G Dotevall.

At least 37 records · Page 2Linked to original sources
PubMed1985

Stress management in the long-term treatment of peptic ulcer disease.

The definition of stress varies from author to author. Whether or not it is experienced depends on the perception of the potentially stress-producing event. Stress can be induced experimentally in animals or human beings in various ways and can arise from a person's occupation, leading to adverse effects such as hypertension, cardiac alterations, increase in gastric acid secretion and the occurrence of peptic ulceration. In man, peptic ulceration may be linked to a dependence-independence conflict. The incidence of duodenal ulcer has been shown to be higher in those from broken homes than from normal homes. In 103 duodenal ulcer patients with high scores for stressful life events followed-up over a 15 month period, the outcome was more favourable in those who received psychotherapy plus intermittent pharmacotherapy than in those who received intermittent pharmacotherapy alone.

Anxiety↗
PubMed1984

Plasma enteroglucagon related to malabsorption in coeliac disease.

Plasma enteroglucagon was measured before and during three hours after a standard meal in 21 untreated adult patients with suspected coeliac disease who all had villous atrophy of the small intestinal mucosa and malabsorption, and in nine control subjects. In 11 of these patients the diagnosis of coeliac disease was confirmed and 10 were again investigated on a gluten free diet. The coeliac patients had higher basal (37 +/- 9 pmol/l, mean +/- SE, p less than 0.05) and postprandial (70 +/- 9 pmol/l, p less than 0.005) mean plasma enteroglucagon concentrations than the control subjects (basal 14 +/- 4 pmol/l, postprandial 25 +/- 5 pmol/l). The 10 coeliac patients on gluten free diet for five to 20 months had a basal mean plasma enteroglucagon concentration not significantly lower than before treatment (25 +/- 5 pmol/l) but significantly lower postprandial enteroglucagon concentrations than before treatment (40 +/- 7 pmol/l, p less than 0.025). Postprandial plasma enteroglucagon concentration after 90 minutes in untreated patients correlated positively to the faecal fat excretion (r = 0.58, p less than 0.02). It correlated negatively to the urinary five hour D-xylose excretion after an oral load of 165 mmol D-xylose (r = -0.71, p less than 0.01). Thus, the postprandial plasma enteroglucagon concentrations in untreated coeliac disease were related to the degree of malabsorption and they normalised during treatment with a gluten free diet.

Adult↗
PubMed1984

Conventional malabsorption tests: do they detect the adult patient with villous atrophy?

A total number of 134 patients with subtotal or partial villous atrophy, of whom 49 had dermatitis herpetiformis, were investigated with blood folate assay and xylose and lactose absorption tests. Faecal fat excretion was determined in 71 patients without dermatitis herpetiformis (coeliac group). A comparison was made between three patient groups, the patients with dermatitis herpetiformis and the coeliac patients studied in 1970-74 and 1975-79, respectively. From clinical and biochemical analyses of these patients we conclude that although a combination of the four malabsorption tests used here still detect a majority of coeliac patients, small intestinal biopsy may reveal villous atrophy also in patients without any laboratory evidence for malabsorption by these commonly used tests. In dermatitis herpetiformis, however, the sensitivity of the tests used was low; these malabsorption tests therefore have little diagnostic value in this category of patients.

Adult↗
PubMed1984

Intragastric bacteria and nitrite after short-term treatment with different doses of antimuscarinic drugs.

In 11 volunteers gastric acid secretion was measured under basal conditions and after modified sham-feeding after 4 1/2 days' treatment with placebo tablets twice daily (placebo), pirenzepine, 50 mg twice daily (pirenzepine), benzilonium bromide, 17.5 mg twice daily (benzilonium 35), or benzilonium bromide, 35 mg twice daily (benzilonium 70), respectively. The first basal portion of gastric fluid was cultured aerobically and anaerobically, and its nitrite concentrations were measured by a colorimetric technique. Basal acid output was reduced 40% by pirenzepine, 71% by benzilonium 35, and 84% by benzilonium 70. Reduction of the stimulated acid output was 47%, 57%, and 74%, respectively. Mean bacterial count (in log10/ml gastric juice) after placebo was 3.50 +/- 0.81 (SEM). Only the treatment with benzilonium 70 gave significantly increased bacterial counts (6.41 +/- 0.68; p less than 0.01). Mean nitrite concentrations (in mumol/l) after placebo, pirenzepine, benzilonium 35, and benzilonium 70 were 2.90 +/- 1.26 (SEM), 3.90 +/- 1.17, 11.36 +/- 7.24, and 18.81 +/- 5.71, respectively. The last value was significantly different from that after placebo (p less than 0.025). Bacterial counts were negatively correlated to basal acid output (p less than 0.001) but not to stimulated acid output. Nitrite was directly correlated to bacterial counts and inversely correlated to basal and stimulated acid output. Even a short-lasting but strong inhibition of gastric acid output by antimuscarinics can change the intragastric milieu significantly. No significant changes occur after moderate reduction of gastric acid output.

Adult↗
PubMed1983

Controlled study of psychotherapy in irritable bowel syndrome.

101 outpatients with irritable bowel syndrome were randomly allocated to two treatment groups. Both groups received the same medical treatment, but patients in one group also received dynamically oriented individual psychotherapy in ten hour-long sessions spread over 3 months. After 3 months there was a significantly greater improvement in somatic symptoms in the psychotherapy group. The difference became more pronounced a year later, with the patients given psychotherapy showing further improvement, and the patients who received medical treatment showing some deterioration. The combination of medical treatment with psychotherapy improves outcome, not only in the short term but also in the long run.

Adolescent↗
PubMed1983

Effects of beta-adrenoceptor blocking drugs on human sigmoid colonic motility.

Effects of propranolol and metoprolol on sigmoid colonic motility were studied in 12 healthy volunteers in a double-blind randomized fashion. Colonic pressure was recorded 15-18 cm from anus and contractile activity quantified for periods of 25 min. On separate days propranolol, metoprolol, and placebo, respectively, was administered intravenously preceded by a control period. After propranolol, 10 mg intravenously, pressure activity increased significantly from 3.8 +/- 1.1 (SEM) kPa X min (28 +/- 8 mm Hg X min) to 5.9 +/- 1.0 kPa X min (44 +/- 8 mm Hg X min) (P less than 0.001). Also, after propranolol, 5 mg intravenously, the pressure activity was increased (P less than 0.05). After metoprolol, 10 mg intravenously, contractile activity increased from 4.3 +/- 0.9 kPa X min (32 +/- 7 mm Hg X min) to 6.1 +/- 1.0 kPa X min (46 +/- 8 mm Hg X min) (P less than 0.01). The two drugs caused equipotent reduction of heart rate. After placebo, no effect on sigmoid pressure or heart rate was observed. The study shows that unselective (propranolol) and beta 1-selective (metoprolol) beta-blocking drugs enhance distal colonic pressure in man. Colonic motility seems to be under sympathetic beta-adrenergic influence even under fairly unstrained conditions.

Adrenergic beta-Antagonists↗
PubMed1983

Endoscopic evaluation of the comparative effects of acetylsalicylic acid and choline magnesium trisalicylate on human gastric and duodenal mucosa.

A new salicylate product, choline magnesium trisalicylate (Trilisate tablets), and acetylsalicylic acid were compared for their local effects in equipotent doses on the gastroduodenal mucosa in a randomized, double-blind, cross-over study, using 10 healthy volunteers. After five-day periods of administration, gastroduodenoscopy was performed and photographs were obtained. All subjects given acetylsalicylic acid developed multiple mucosal lesions, but in only four subjects given choline magnesium trisalicylate were slight mucosal changes noted. Mean serum salicylate levels were similar in the two groups. Our data suggest that the risk of developing mucosal lesions is much less during treatment with choline magnesium trisalicylate than with acetylsalicylic acid.

Adult↗
PubMed1983

Evaluation of gliadin antibodies for detection of coeliac disease.

To evaluate assay of gliadin antibodies of different immunoglobulin classes as a test for detection of coeliac disease, we analysed sera from 36 adult patients and 8 children with coeliac disease, 62 patients with other gastrointestinal diseases, and 124 blood donors with diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA). Depending on the choice of reference levels for gliadin antibodies of the IgA and IgG classes, respectively, we found a diagnostic sensitivity for coeliac disease of 93-86% and a diagnostic specificity of 95-100%. Determination of gliadin antibodies by DIG-ELISA can thus be used as a test for detection of coeliac disease and selection of patients for small-intestinal biopsy.

Adolescent↗
PubMed1982

Chronic inflammatory bowel disease in patients with coeliac disease.

Six patients with coeliac disease and inflammatory bowel disease are described. Of special interest were two patients with coeliac disease and dermatitis herpetiformis and ulcerative colitis, one of whom also had sclerosing cholangitis. Three patients had both coeliac disease and ulcerative colitis, and one of them also had sclerosing cholangitis. In one patient with coeliac disease Crohn's disease of the small bowel was diagnosed. There seems to be association between coeliac disease without dermatitis herpetiformis, and ulcerative colitis. The possible combination of coeliac disease and inflammatory bowel disease deserves more attention than it has hitherto received.

Adult↗
PubMed1982

The effect of different doses of pirenzepine on gastric secretion stimulated by modified shamfeeding in man.

It is known, that Pirenzepine inhibits basal, pentagastrin-, insulin- and peptone-stimulated gastric secretion. In this study the effect of three different doses of Pirenzepine was studied on acid secretion stimulated by modified shamfeeding (MSF). Each of eleven healthy volunteers underwent four secretion tests after pre-treatment for 4 days in random order by: no drug, tablets Pirenzepine 25 mg b.i.d., 50 mg b.i.d., or 50 mg t.d.s. Basal acid output 0-30' was reduced by 48%, 59% and 66% respectively and stimulated acid output 0-120' by 45%, 58% and 48% respectively. When acid secretion was calculated as volume corrected for duodeno-gastric reflux and pyloric losses the corresponding figures were 33.7%, 36.3% and 42.6%. Inhibition of MSF-stimulated acid secretion by a high dose of Pirenzepine was not complete. Pirenzepine 50 mg b.i.d. seems to be a suitable dose for clinical use, as acid reduction is as good as with 50 mg t.d.s. and side-effects are known to be less.

Adult↗
PubMed1982

Symptoms in irritable bowel syndrome.

In a consecutive study of 101 patients with IBS and at least one year of complaints, the presence of somatic and mental symptoms were measured. By definition all patients had abdominal pain and/or disturbed bowel function in the absence of organic disease. The most prominent symptom of indigestion was abdominal distension. Many patients also had complaints of food intolerance and avoided bulk forming agents such as fruits and vegetables. Symptoms associated with the upper gastrointestinal tract such as burning sensations in the epigastrium nausea and acid regurgitation were seen in a majority of the patients. Mental symptoms were seen in almost all patients. A majority had complaints of inner tension, worrying over trifles, autonomic disturbances and muscular tension. Symptoms referred to the neurasthenic syndrome were also frequently seen, such as fatiguability and irritable and hostile feelings. Common depression symptoms were sadness and feelings of helplessness. Other mental symptoms of importance were phobias, sleep disturbances, reduced sexual interest, loss of appetite and obsessive-compulsive symptoms. Our conclusion is that patients with IBS frequently have upper gastrointestinal and mental symptoms which should be taken into account searching for more rational methods of treatment.

Abdomen↗
PubMed1981

The effect of pirenzepine and L-hyoscyamine on gastric emptying and salivary secretion in healthy volunteers.

Pirenzepine is used in the treatment of peptic ulcer disease as an inhibitor of gastric acid secretion. Recent studies suggest that the mode of action on the stomach may be selectively anticholinergic. The present study was undertaken to compare the effect of pirenzepine on gastric emptying with the effect of a widely used classical anticholinergic drug and of placebo. In a double-blind double-dummy study nine healthy volunteers received 50 mg pirenzepine twice a day, 0.6 mg L-hyoscyamine twice a day, or two placebo tablets twice a day for 4 days before the gastric emptying test. Gastric emptying of a liquid test meal was measured by the method of George. Maximum salivation capacity was registered by the method of Blum 2 and 4 h after the last dose had been given. Gastric emptying was delayed during L-hyoscyamine, whereas the emptying was slightly accelerated by pirenzepine when compared with placebo. The difference between L-hyoscyamine and pirenzepine was statistically significant for the time in which the volume fell to 75% and 50% (p less than 0.01). The salivation was significantly more inhibited by L-hyoscyamine than by pirenzepine. Pirenzepine in doses inhibiting gastric acid secretion does not delay gastric emptying when compared with an equipotent dose of a classical anticholinergic drug, nor does it inhibit salivary secretion as much as L-hyoscyamine. This study therefore confirms our previous conclusion that pirenzepine may indeed be a 'selective' anticholinergic drug acting on gastric secretion.

Adult↗
PubMed1981

Effects of propranolol on colonic pressure in patients with irritable bowel syndrome.

The effect of propranolol on colonic motility was studied in 10 patients with irritable bowel syndrome. Colonic motility was recorded by pressure measurement 15-18 cm from the anus, and total contractile activity (kPa x min) simultaneously integrated. After rest, motility was recorded for 30 min after injection of saline (control period) and after injection of 5 mg propranolol intravenously. Administration of propranolol was followed by an increase in colonic motility in 9 out of the 10 patients. In one patient no change was observed. During the control period, total contractile activity was 7.7 +/- 18 (S.E.M.) kPa x min (58 +/- 14 mmHg x min), increasing after propranolol to 14.2 +/- 2.3 kPa x min (107 +/- 17 mmHg x min). The difference was significant (p less than 0.01). After propranolol, the colonic pressure waves regularly appeared for longer periods of time and had higher amplitudes than during control activity. Prolonged elevation of basal pressure with superimposed pressure waves was observed in two patients. This study shows that adrenergic beta-blocking agents enhance colonic motility in man. The results may explain abdominal symptoms such as pain and change in bowel habits appearing in patients treated with beta-blocking drugs.

Adult↗