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Biomedical subjects

G F Longstreth

Publications and source records attributed to G F Longstreth.

65 records · Page 4Linked to original sources
PubMed1977

Gastric secretion and emptying after ordinary meals in duodenal ulcer.

We have studied the gastric response to an ordinary solid-liquid meal in 12 patients with active duodenal ulcer and 8 healthy volunteers. Our method employs gastric and duodenal markers to quantify acid, pepsin, and volume outputs in response to the meal, without manipulating intragastric pH. Intragastric volume, rate of gastric emptying, delivery of acid into the duodenum, and serum gastrin response were also measured simultaneously. On a separate day, peak acid output in response to betazole (1.5 mg per kg subcutaneously) was determined. Our results indicate an inappropriately prolonged gastric secretory response to meals in duodenal ulcer disease, without a concomitant increase in peak postprandial secretory rates or an increase in serum immunoreactive gastrin levels. Further, the stomach in duodenal ulcer disease did not "retain" the additional acid secreted in the later postprandial period, and abnormally high rates of acid delivery into the duodenum occurred. Our data are consistent with a dual defect in the duodenal mechanisms regulating both acid secretion and acid delivery into the duodenum.

Adult↗
PubMed1976

Cimetidine suppression of nocturnal gastric secretion in active duodenal ulcer.

Nocturnal pain and gastric hypersecretion are common in duodenal ulcer. Therefore, we investigated the antisecretory effects of a new H2-receptor antagonist, cimetidine, in 200-, 300- or 400-mg doses, taken orally at bedtime. The 200-mg dose did not cause a statistically significant change in nocturnal (midnight to 7 a.m.) acid output and had only a borderline effect on pH. However, the 300-mg and 400-mg doses significantly (P less than 0.001) lowered acid output and increased (P less than 0.01) intragastric pH. All doses caused substantial decreases in secretory volume output. After a 400-mg dose, half the patients remained anacidic for eight hours. Dose-related increases of drug blood levels were observed and correlated with the degree and duration of inhibition of acid output. Serum gastrin levels were unaffected. Cimetidine appears to be a potent inhibitor of nocturnal gastric secretion.

Administration, Oral↗
PubMed1976

Measurement of gastric functions during digestion of ordinary solid meals in man.

A method of measuring gastric secretions and emptying rates after ingestion of an ordinary (solid-liquid) meal has been developed and validated. The technique quantifies movements of volume across the pylorus using constant duodenal perfusion with a nonabsorbable marker, polyethylene glycol (PEG), which, in turn, quantifies emptying into the duodenum of another marker, [14C]PEG, incorporated in the meal. Acid and pepsin outputs can be determined without manipulation of the intragastric pH. Employing this method, we have simultaneously quantified acid, pepsin, and total secretory outputs; rates of gastric emptying of meal and secretions; and serum gastrin levels during digestion. These data characterize physiological responses to ordinary food in health.

Adult↗
PubMed1975

The gastric response to a transpyloric duodenal tube.

The quantification of gastric, pancreatic, biliary, and small bowel functions in man often requires the use of intestinal tubes. In this study, the presence of a transpyloric tube did not alter gastric emptying, acid secretion, or serum gastrin levels in response to an ordinary solid meal.

Adult↗
PubMed1975

Bronchiectasis and homozygous alpha1-antitrypsin deficiency.

A 34-year-old woman with homozygous a1-antitrypsin deficiency suffered from progressive, generalized cystic bronchiectasis. Although bronchiectasis was reported in the original monograph on the enzyme inhibitor deficiency, it has received minimal attention since then. Alpha1-antitrypsin levels should be measured in patients with severe bronchiectasis.

Adult↗
PubMed1975

Drug-induced malabsorption.

Pharmacologic agents of diverse types may alter gastrointestinal absorption of nutrients and other substances. Mechanisms underlying drug-induced absorptive defects that have been documented include: (1) a direct toxic effect causing morphologic changes in the mucosa of the small intestine; (2) inhibition of mucosal enzymes with or without morphologic evidence of mucosal damage; (3) binding and precipitation of micellar components, such as bile acids and fatty acids; and (4) alteration of the physicochemical state of another drug or dietary ion. The malabsorptive effect generally is dose-related, rather than an idiosyncratic reaction, and usually involves multiple nutrients. Certain clinical states, such as in the malnourished alcoholic may predipose the gastrointestinal tract to a drug-induced absorptive defect. For this review we discuss in detail nine commonly used drugs or types of drugs that cause malabsorption of dietary nutrients or other medications.

Alcoholism↗
PubMedDate not supplied

Long-term costs after gastroenterology consultation with endoscopy versus radiography in dyspepsia.

A randomized clinical trial assessed the medical costs during 6 months after the evaluation of dyspepsia by gastroenterology consultation with esophagogastroduodenoscopy versus barium radiography. Primary care physicians entered patients whose dyspepsia responded incompletely to empiric therapy or recurred. The consultation/endoscopy group (N = 32) was similar (p greater than 0.23) to the radiography group (N = 34) regarding age, gender, physician visits, and costs of all dyspepsia drugs and H2 blockers during 6 months before evaluation. Most patients had non-ulcer dyspepsia. Costs during the succeeding 6 months (consultation/endoscopy versus radiography groups) were physician visits ($33.1 +/- 14.5 vs. $114.2 +/- 23.3, p less than 0.005); radiologic procedures ($70.5 +/- 37.3 vs. $67.6 +/- 22.5, p greater than 0.30); all dyspepsia drugs ($30.4 +/- 10.0 vs. $100.1 +/- 36.8, p = 0.08); H2 blockers ($25.4 +/- 9.5 vs. $96.0 +/- 34.7, p = 0.06); and total cost ($134.0 +/- 43.8 vs. $435.3 +/- 93.9, p = 0.006). The higher total cost in the radiography group was partly due to the referral of 7 patients (21%) for gastroenterology consultation due to persistent dyspepsia, 6 of whom had endoscopy versus the performance of radiography in 0 of the 32 consultation/endoscopy patients (p less than 0.025). Dyspepsia self-ratings were similar.

Adult↗