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Biomedical subjects

J J Misiewicz

Publications and source records attributed to J J Misiewicz.

At least 91 records · Page 5Linked to original sources
PubMed1988

Future trends in the management of peptic ulcer disease.

Future trends in the short- and long-term management of peptic ulcer disease are considered. The present state of development of pharmacologic agents for the short-term healing of duodenal and gastric ulcer is impressive, and high rates of healing with rapid symptom relief can be safely achieved with several agents. The problem of ulcer recurrence has not been solved, although new work concerning the role of Campylobacter pylori holds promise. The mortality of acute gastrointestinal haemorrhage remains unacceptably high, especially in the elderly. Therapeutic endoscopy may be effective in decreasing the death rate from bleeding.

Anti-Ulcer Agents↗
PubMed1988

Manipulation of gut hormone response to food by soluble fiber and alpha-glucosidase inhibition.

Preliminary data indicated that viscous fiber (guar) and alpha-glycosidase inhibition (acarbose) used in combination to slow carbohydrate absorption have an apparently additive effect in reducing the postprandial glycemic response. The full endocrine data reported here also demonstrate that reductions in insulin and gastric inhibitory polypeptide are most significant when guar and acarbose are used in combination. The results are divergent for enteroglucagon when guar and acarbose were given singly. Raised enterglucagon levels seen after acarbose are in keeping with inhibition of proximal absorption resulting in more distal absorption of carbohydrate. However, with viscous fiber, the enteroglucagon response was reduced, and this reduction was maintained even after addition of acarbose. The results demonstrate that the gut endocrine response can be manipulated by pharmacological interventions which alter the pattern of carbohydrate absorption.

Acarbose↗
PubMed1987

What is new in the epidemiology and pathogenesis of peptic ulcer?

The old dictum 'no acid--no ulcer' is no longer a sufficient explanation of the pathogenesis of ulcer disease. The real question is 'if acid--why ulcer?' Although acid remains predominant, some of the other factors influencing ulcerogenesis are nocturnal acid secretion, pepsin enzyme subspecies, the mucus layer, bicarbonate levels, prostaglandins, Campylobacter pylori infection, consumption of non-steroidal anti-inflammatory drugs, and smoking habits. Although the ulcer burden has been greatly reduced by the introduction of H2-receptor antagonists, complications such as bleeding and perforation remain a problem, especially in the elderly. Medical treatment, in the form of H2-receptor antagonists, is effective for many patients.

Humans↗
PubMed1987

Effects of one year's treatment with ranitidine and of truncal vagotomy on gastric contents.

Fifteen patients with peptic ulcer underwent 24 hour studies of gastric contents: before and on completing six weeks' treatment with oral ranitidine 150 mg bd, twice on maintenance treatment for nine to 12 months and one month after stopping the drug. For comparison, 11 patients underwent identical 24 hour studies three to 38 months after truncal vagotomy for duodenal ulcer. During treatment with ranitidine median 24 hour intragastric pH, nitrate concentration, and counts of total and nitrate reducing bacteria increased significantly regardless of dietary nitrate content; there was no significant increase in the median day time concentration of N-nitroso compounds. Despite these changes, an acid tide at some point in each 24 hour study period prevented persistent bacterial colonisation of the stomach. There were no significant differences between the biochemical and microbiological changes recorded during one year of treatment with ranitidine, and the observations on patients after truncal vagotomy. One month after stopping one year's treatment with ranitidine all variables examined returned to pretreatment levels. Treatment with ranitidine or vagotomy was associated with significant positive correlations among pH, nitrate concentration and bacterial counts. Correlations between pH and N-nitroso compound concentration and between concentrations of nitrite and N-nitroso compounds were not significant.

Adult↗
PubMed1986

Investigation of ranitidine 150 mg bd or 300 mg bd in the treatment of reflux disease.

Twenty patients with symptoms and endoscopic changes of gastro-oesophageal reflux were randomly allocated to treatment with either ranitidine 150 mg bd, or 300 mg bd for 8 weeks. Symptoms, endoscopic appearances, histopathology of oesophageal biopsies and 22-h intra-oesophageal pH profile in ambulant patients on standard diets were recorded before and at the end of the treatment period. Symptoms improved rapidly and markedly on either dose of ranitidine. Both doses produced significant improvement of the endoscopic appearances, but there were no differences in symptomatic and endoscopic improvement related to the dose. Biopsy appearances and the 22-h oesophageal pH profile remained unchanged on either dose of ranitidine.

Adult↗
PubMed1985

Antral hypertrophic gastritis: a rare cause of iron deficiency.

A case of an unusual hypertrophic gastropathy confined to the gastric antrum which presented with chronic anaemia is described. The clinical and pathological features are contrasted with Menetrier's disease and hypersecretory hypertrophic gastropathy, and a possible relation to solitary hyperplastic (regenerative) polyps is discussed.

Aged↗
PubMed1984

The ileal brake--inhibition of jejunal motility after ileal fat perfusion in man.

The possibility that malabsorbed fat passing through the human ileum exerts an inhibitory feedback control on jejunal motility has been investigated in 24 normal subjects by perfusing the ileum with a fat containing solution designed to produce ileal luminal fat concentrations similar to those in steatorrhoea (30-40 mg/ml). Mean transit times through a 30 cm saline perfused jejunal segment were measured by a dye dilution technique. Thirty minutes after ileal fat perfusion, mean transit times rose markedly to 18.9 +/- 2.5 minutes from a control value of 7.5 +/- 0.9 minutes (n = 5; p less than 0.05). This was associated with an increase in volume of the perfused segment which rose to 175.1 +/- 22.9 ml (control 97.6 +/- 10.3 ml, n = 5; p less than 0.05). Transit times and segmental volumes had returned towards basal values 90 minutes after completing the fat perfusion. Further studies showed that ileal fat perfusion produced a pronounced inhibition of jejunal pressure wave activity, percentage duration of activity falling from a control level of 40.3 +/- 5.0% to 14.9 +/- 2.8% in the hour after ileal perfusion (p less than 0.01). Ileal fat perfusion was associated with marked rises in plasma enteroglucagon and neurotensin, the peak values (218 +/- 37 and 68 +/- 13.1 pmol/l) being comparable with those observed postprandially in coeliac disease. These observations show the existence in man of an inhibitory intestinal control mechanism, whereby ileal fat perfusion inhibits jejunal motility and delays caudal transit of jejunal contents.

Adult↗
PubMed1984

Comparison of ranitidine and cimetidine maintenance treatment of duodenal ulcer.

Sixty-one patients with healed duodenal ulcer were studied during a 12-month maintenance trial with either 150 mg ranitidine at night or 400 mg cimetidine at night. Recurrences were determined at endoscopy after 6 and 12 months of treatment or because of symptomatic relapse. Ulcers recurred in 7 of 28 patients receiving ranitidine and in 8 of 33 patients receiving cimetidine. No serious side effects were encountered.

Adolescent↗
PubMed1984

Human colonic motility.

Abnormalities of colonic motility are believed to play a major role in many alimentary disorders. Progress in devising suitable therapies has been hampered by imperfect understanding of the complex factors that control colonic motility. Intrinsic and extrinsic nerves, endocrine and paracrine factors and the nature of the luminal contents all affect colonic motor activity (propulsive or segmental) in various degrees, the relative importance of which is difficult to assess. Recent evidence concerning these influences and abnormalities of colonic motility in various diseases is reviewed.

Colon↗
PubMed1983

Assessment of the reproducibility of the lactulose H2 breath test as a measure of mouth to caecum transit time.

The lactulose H2 breath test is in use as a simple non-invasive measurement of mouth to caecum transit time, but its reproducibility has never been assessed. We have examined the reproducibility of mouth to caecum transit time in 21 normal subjects using lactulose 10, 15, and 20 g; seven subjects being studied with 10 g and 12 each with 15 and 20 g doses. Transit time decreased with increasing doses of lactulose although the differences were not significant between or within (n = 5) individuals. Variation in transit times between individuals was considerable with all doses of lactulose (mean coefficient of variation of 18.5, 29.7 and 28.3% with 10, 15, and 20 g respectively). The addition of lactulose to a liquid meal containing carbohydrate, fat, and protein decreased the coefficient of variation to less than 10% in four subjects studied. The lactulose H2 breath test could be made more reproducible by including a liquid meal.

Adult↗
PubMed1982

Effect of transdermally administered hyoscine methobromide on nocturnal acid secretion in patients with duodenal ulcer.

Use of anticholinergic drugs in treatment of duodenal ulcers is limited by the side effects of widespread parasympathetic blockade evoked by usual therapeutic doses. A study was conducted into the effectiveness of transdermal delivery of hyoscine methobromide using a new system which releases the drug into the circulation at a controlled rate. In six patients whose duodenal ulcer had healed secretion of acid was measured over two nights, the first on placebo and the second on hyoscine methobromide. All patients responded to the active drug and showed a significant inhibition of acid secretion. Four subjects complained of a dry mouth after overnight treatment with hyoscine methobromide; no other side effects were reported. Transdermal delivery of anticholinergic drugs may be useful in maintenance treatment of duodenal ulcers and further clinical tests are indicated.

Adult↗