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Biomedical subjects

L Elsborg

Publications and source records attributed to L Elsborg.

At least 37 records · Page 2Linked to original sources
PubMed1992

Effect of cisapride on relapse of reflux oesophagitis, healed with an antisecretory drug.

Maintenance treatment with cisapride was evaluated in 298 patients in whom reflux oesophagitis had been healed with antisecretory drugs. Initially, 34% of the patients had grade-I oesophagitis, 33% had grade II, and 33% had grade III. The patients were treated with 20 mg cisapride twice daily or placebo for 6 months or until endoscopic relapse was shown if this occurred earlier. Survival analysis showed that cisapride significantly prolonged the time to endoscopic relapse in grade-I patients (P = 0.02). The intergroup difference in symptomatic relapse in all patients was also significant (P = 0.010). The effect of cisapride was less clearcut in grade II or III, and/or in patients healed with omeprazole. Factors associated with early relapse were placebo therapy, prior omeprazole therapy, duration of pre-trial symptomatic period, and initial endoscopic severity grade. Adverse experiences were limited; diarrhoea was reported by 9% of the cisapride patients.

Anti-Ulcer Agents↗
PubMed1992

Prevalence of antibodies against heat-stable antigens from Helicobacter pylori in patients with dyspeptic symptoms and normal persons.

Heat-stable antigens from Helicobacter pylori were investigated for the detection of serum IgG, IgA and IgM antibodies against H. pylori by an ELISA technique. Antibody titers against H. pylori were measured in 167 dyspeptic patients, of whom 96 were H. pylori positive confirmed by culture or microscopy, and in 482 controls (0-98 years). Increased IgG antibody titers were found significantly more often in dyspeptic patients with active chronic gastritis than in patients with normal morphology, as well as in H. pylori-positive patients as compared to H. pylori-negative patients, independent of the endoscopic findings. The heat-stable antigens were compared with acid glycine-extracted antigens and a high degree of concordance was found in the results obtained with the two antigen preparations. The differences in the IgA antibody titers against H. pylori between H. pylori-positive and H. pylori-negative dyspeptic patients were significant and may be useful to confirm a borderline IgG result. No differences were found in IgM antibody titer between H. pylori-positive and -negative patients. The greatest age-dependent increase in IgG and IgA antibody titers was found in children, and if a lower cut-off level is used for children than for adults, as has been proposed, the proportion of people with increased antibody titers against H. pylori would be almost constant from the age of between five and 10 years until the time between 61 and 80 years. Comparison of H. pylori IgG antibodies with IgG antibodies against Campylobacter jejuni and total antibodies against cytomegalovirus (CMV) showed a greater similarity between H. pylori and C. jejuni (R = 0.51) than between H. pylori and CMV (R = 0.22). This may possibly be caused by cross-reactions between H. pylori and C. jejuni. The H. pylori heat-stabile antigen seems not to be very different from other crude H. pylori antigens like acid glycine-extracted antigens, but purification and characterization of the antigens are needed to improve antibody assays.

Adolescent↗
PubMed1991

Sucralfate versus cimetidine in the treatment of reflux esophagitis, with special reference to the esophageal motor function.

Sixty patients entered a double-blind clinical trial comparing the effect of 1 g of sucralfate granulate given four times daily and cimetidine, 400 mg twice daily. Twenty-six patients treated with sucralfate and 26 treated with cimetidine were examined with short-term pH monitoring before and after 12 weeks of treatment. Thirty patients, 19 treated with cimetidine and 11 treated with sucralfate, had esophageal motility studied by a radionuclide test before and after 12 weeks of treatment. The efficacy of the treatments was judged by symptoms and endoscopic response after 4, 8, and 12 weeks of treatment. The endpoint healing rate was approximately 60% in both groups and symptoms were relieved in half of the patients in both groups (difference not significant). The effect of the treatments on pH and number of spikes reflected the different pharmacodynamic profiles of the drugs, whereas the mean transit time (MTT) was not changed by the treatments. The residual activity after radionuclide transit in the sitting position was significantly increased after treatment with cimetidine. The data support the hypothesis that primary dysmotility might be involved in the pathogenesis of reflux esophagitis in about 33% of the patients. Possibilities for a combination therapy with sucralfate and cimetidine are stressed.

Adolescent↗
PubMed1991

The Helicobacter (Campylobacter) pylori-colonized duodenal mucosa and gastric metaplasia.

Biopsies were obtained from non-ulcerated sites of the duodenum from 100 dyspeptic patients. Helicobacter (Campylobacter) pylori was cultivated from 19 of these biopsies. Active chronic duodenitis (ACD) was found in 17 biopsies and more than 5% gastric metaplasia in 20 biopsies. H. pylori as well as ACD occurred with a significantly increased frequency when more than 5% gastric metaplasia was found in the duodenal biopsies. H. pylori on metaplastic tissue without ACD was, however, seen in two cases. H. pylori was cultivated from 9% and ACD was found in 5% of the biopsies with less than 5% gastric metaplasia. Gastric metaplasia in the duodenum was found significantly more frequently in patients with endoscopic duodenitis or duodenal ulceration than in patients with normal endoscopy. No association between gastric metaplasia in the duodenum and gastric pH or serum antibodies against H. pylori was seen. This study indicates that there is an established, but not exclusive, connection between gastric metaplasia and the colonization of the duodenum by H. pylori, the most important role being played by the antral gastric mucosa rather than the duodenum.

Biopsy↗
PubMed1991

Effect of intravenous omeprazole on twenty-four-hour intragastric pH in patients with a history of peptic ulcer. Comparison of two four-dosage regimens.

To study the effect of intravenously given omeprazole on the 24-hour gastric secretion, 9 male patients with previously endoscopic proven duodenal ulcer disease were studied. Two four-dose regimens only differing in loading doses were compared. The study showed that 40 mg omeprazole, administered intravenously 4 times a day, is able to keep the gastric pH above 4 in 85% of the 24-hour study period and in 65% of the time pH was above 6. The corresponding values from the baseline period were 10 and 6%. There was no additional effect by a larger loading dose.

Double-Blind Method↗
PubMed1991

Sucralfate versus cimetidine in reflux oesophagitis. A double-blind clinical study.

Sixty patients with endoscopically verified oesophagitis entered a double-blind clinical study comparing 1 g sucralfate granulate given four times daily and 400 mg cimetidine twice daily. The efficacy, as judged by endoscopy and the symptomatic response, were studied after 4, 8, and 12 weeks of treatment. Macroscopic healing of oesophagitis was defined as complete epithelialization of all oesophageal erosive lesions classified in accordance with Savary-Miller. Groups were comparable with regard to demographic data. The healing rate at 12 weeks' end point was 62% in the sucralfate group and 59% in the cimetidine group (NS). Half of the patients in both groups (NS) were relieved of symptoms. No adverse effects were recorded. Sucralfate and cimetidine appear to be equally efficient in the treatment of reflux oesophagitis.

Cimetidine↗
PubMed1991

Sucralfate versus cimetidine in reflux oesophagitis. The effect on oesophageal pH and motility.

Sixty patients with endoscopically verified oesophagitis entered a double-blind study comparing the effect of 1 g of sucralfate granulate given four times a day and cimetidine, 400 mg twice a day. Fifty-two patients, 26 treated with cimetidine and 26 with sucralfate, were examined with short-term pH monitoring before and after 12 weeks of treatment. In about half of the patients, 19 treated with cimetidine and 11 treated with sucralfate, the oesophageal motility was studied with a radionuclide test before and after treatment. The sucralfate treatment did not affect either mean pH or the emptying rate but reduced the number of spikes. The cimetidine treatment increased mean pH and reduced the number of spikes but did not affect emptying rates. Both groups had significantly prolonged mean transit time (MTT) compared with healthy volunteers. MTT did not change after either treatment. The residual activity in the sitting position was significantly increased after cimetidine. It is concluded that the pharmacodynamic effect on oesophageal motility is different for the two drugs in question. Primary dysmotility might be involved in the pathogenesis of oesophagitis.

Adolescent↗
PubMed1990

[Runner's diarrhea].

Two cases of diarrhoea occurring during running training are presented. It is suggested that relative ischaemia of the gut may be responsible for the condition during prolonged strenuous exercise.

Adult↗
PubMed1989

Rectosigmoid motility response to sham feeding in irritable bowel syndrome. Evidence of a cephalic phase.

Rectosigmoid pressure recordings by means of open-ended perfused catheters were performed on 21 patients with the irritable bowel syndrome (IBS). Motility indexes were calculated in resting conditions, after sham feeding, after a meal, and after 0.5 mg neostigmine intravenously. Each step of stimulation caused a significantly increased motility index compared with the previous step (p less than 0.01). The increase in rectosigmoid pressure activity after sham feeding indicates the existence of a cephalic phase in the postprandial motor response of the colon in IBS.

Adult↗
PubMed1988

Campylobacter pylori in peptic ulcer disease. III. Symptoms and paraclinical and epidemiologic findings.

Only a few publications have dealt with the subjective symptoms, the paraclinical findings, or the epidemiology in relation to cultivation of C. pylori. Seventy-two patients answered a questionnaire containing questions about symptoms, dietary habits, smoking, and animal contact. C. pylori was cultivated from the biopsy specimens of 41 of these patients, and 31 were culture-negative. In addition, leukocyte count, differential count, and blood immunoglobulins were measured. In many culture-positive patients a variation in symptoms during the year was found, and symptoms had lasted more than 5 years. This was statistically significant for non-ulcer patients. In addition, we found initial abdominal pain and present vomiting to be significant features, but they did not seem to have any clinical significance. Unlike Marshall & Warren, we did not find ructus to be related to infections with C. pylori. In all other respects we found no differences between culture-negative and culture-positive patients. It was not possible to detect any descriptive variables in patients with C. pylori infections.

Adult↗
PubMed1988

The diagnostic value of computerized short-term oesophageal pH-monitoring in suspected gastro-oesophageal reflux.

In 109 consecutive patients suspected of having gastro-oesophageal reflux (GOR) a 3.5-h pH-monitoring in the oesophagus was performed during the daytime. The data were stored in a portable recording system, and three different variables (mean pH, mean acid clearance rate, and number of spikes) were calculated. Compared with a combined endoscopic-histologic score for the diagnosis of oesophagitis, assumed to be due to GOR, the 3.5-h pH-monitoring had a sensitivity of 85% and a specificity of 81%. The data suggest that the short-term pH-monitoring is almost as accurate as the traditional 24-h pH-monitoring and more convenient both for the patient and the gastroenterologic unit.

Adolescent↗
PubMed1988

Campylobacter pylori in peptic ulcer disease. II. Endoscopic findings and cultivation of C. pylori.

Specimens from 153 consecutive patients were cultivated for C. pylori, and findings were correlated to the endoscopic findings. C. pylori was cultivated more frequently from males than from females. Culture-positive males had a high frequency of prepyloric abnormalities. No correlation between age or pH in gastric juice and cultivation of C. pylori was found. C. pylori was found significantly more often in patients with peptic ulcer and/or duodenitis than in patients with normal endoscopic findings. No differences could be detected between patients with gastritis or esophagitis and patients with normal endoscopic findings. C. pylori was found most frequently in the antral part of the stomach. It was cultivated significantly more often from patients with duodenal abnormalities than from patients with normal endoscopic findings. In less than half of the culture-positive patients with duodenal abnormalities we cultivated C. pylori from duodenal specimens. This study also showed C. pylori in esophageal specimens, which has not been previously described. Our results suggest that cultivation of C. pylori from duodenal specimens or gastric fluid samples gives no additional information beyond that obtained from the cultivation of antral biopsy specimens. It is our opinion that C. pylori, at least in some cases, may be a secondary infection.

Adolescent↗
PubMed1987

Endoscopic retrograde pancreatography and exocrine pancreatic function.

The incidence of pancreatitis has been increasing during the last decennium paralleling a rapid enhancement in alcohol consumption. For many years, diagnostic criteria of chronic pancreatitis were exclusively based on the estimation of the exocrine pancreatic function. New valuable information is provided from endoscopic retrograde pancreaticography (ERP) and pancreatic ultrasonography. In a consecutive series of patients with chronic alcoholism changes in the pancreatogram were demonstrated in approximately 44% of the patients. A comparative study of ERP and exocrine pancreatic function showed that only patients with advanced pancreatic lesions had a significant reduction in pancreatic function. It is suggested that 'subclinical pancreatitis' is frequent among alcoholics. Complementary use of pancreatic ultrasonography and ERP gives a differentiated picture of pancreatic disease and is recommended among the first steps in the diagnostic chain for pancreatic disease.

Alcoholism↗
PubMed1987

Campylobacter pyloridis in peptic ulcer disease. I. Gastric and duodenal infection caused by C. pyloridis: histopathologic and microbiologic findings.

In this study 153 patients with dyspepsia were biopsied in the gastric antrum and duodenum. All specimens were investigated histopathologically and microbiologically for the presence of Campylobacter pyloridis, and the type of inflammation was recorded in accordance with Morson's criteria. C. pyloridis was found beneath the mucus close to the epithelial cells and mostly in connection with granulocytic infiltration (active gastritis). C. pyloridis was cultured from all of 10 patients with histologically active gastritis and active duodenitis, in 86% of 64 patients with active gastritis and morphologically normal duodenum, and in only 5% of 79 patients without morphologic gastric and duodenal changes. The close relation between active gastritis and C. pyloridis shows that C. pyloridis plays an important role in gastric inflammation, as it fulfils the criterion for a localized bacterial infection.

Adolescent↗
PubMed1987

Oesophageal reflux disease. Diagnosis, pathophysiology and treatment with special reference to the role of sucralfate.

The direct cause of oesophageal reflux disease is readily apparent, as oesophageal reflux of gastric contents has a deleterious effect on the oesophageal mucosa. Reflux is a direct result of a multiplicity of aetiological factors which interact in many ways. The symptoms of the disorder can masquerade as other conditions such as cardiovascular, respiratory and abdominal problems. The diagnosis is suggested from the symptoms and confirmed by endoscopy with biopsy. Among additional diagnostic test, oesophageal pH monitoring using a portable system is a simple procedure providing qualitative and quantitative information appropriate for clinical practice. A critical review of drug therapy shows that antacids and alginate acid have no greater value than a placebo. The effects of H2-receptor antagonists are under investigation, but the results are conflicting. Ranitidine seems to have some advantages over cimetidine. Antepsin, a new cytoprotective principle for treating ulcerative inflammations in the upper digestive tract, provides an interesting alternative for the treatment of gastro-oesophageal reflux disease, and the properties of Antepsin granulate seem especially appropriate for the treatment of reflux oesophagitis. During longitudinal treatment of three months provides at least partial restoration of the motor function of the distal oesophagus.

Adult↗