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Biomedical subjects

M Guslandi

Publications and source records attributed to M Guslandi.

At least 19 recordsLinked to original sources
PubMed1992

Breakdown of mucosal defences in congestive gastropathy in cirrhotics.

The gastric mucus-bicarbonate barrier, the first line of mucosal defence, has been evaluated in patients with congestive gastropathy and cirrhosis of the liver. Fourteen cirrhotic patients of both sexes (Child's class A or B), with or without oesophageal varices, but with endoscopic signs of congestive gastropathy, and a matched group of healthy controls were studied. The amount of luminal mucoproteins, a Mucoprotective Index as a qualitative assessment of mucus secretion and the output of gastric bicarbonate were determined in basal conditions. In patients with congestive gastropathy a significant (p < 0.01) reduction in all the above parameters was observed, suggesting a substantial impairment of the gastric mucus-bicarbonate barrier. Whether this is an independent phenomenon or a consequence of altered local microcirculation remains to be determined.

Aged↗
PubMed1992

Follow-up of endoscopic gastritis after healing with sucralfate or an H2-receptor antagonist.

48 patients in whom previous endoscopic signs of chronic gastritis had been abolished by treatment with either 1 g sucralfate three times daily or 40 mg famotidine at night were followed up for 3 months without further therapy. Cumulative endoscopic relapse rates at 3 months were 21.7% in the sucralfate group and 57.1% in the famotidine group (p = 0.017). All patients with endoscopic recurrence of gastritis also reported recurrence of dyspeptic symptoms of various degrees. Most patients with endoscopic relapse had persisting histologic gastritis, but up to 67% of subjects with histologic gastritis at the time of initial endoscopic healing did not have subsequent endoscopic or clinical recurrence. It is concluded that gastritis, especially if histologically active, tends to recur quickly after endoscopic healing and that early relapses are significantly more frequent after treatment with an H2 blocker than after sucralfate.

Famotidine↗
PubMed1992

Omeprazole-induced changes in gastric mucus secretion.

The influence of omeprazole treatment on gastric mucus secretion in man was examined in two separate studies. 24 outpatients with endoscopic duodenitis but normal gastric mucosa were treated under double-blind conditions with either omeprazole 20 mg o.m. or placebo for four weeks. Omeprazole was found to induce a significant reduction (p less than 0.001) in the amount of neutral and total mucoproteins into the gastric juice and in the viscous and protective properties of mucus as assessed by a Mucoprotective Index. In a subsequent study 12 omeprazole-treated patients were re-examined either 10 days (6 patients) or 15 days (6 patients) after the drug withdrawal. A trend towards normalization of mucus secretion was detectable already after 10 days, but only at 15 days did gastric mucus fully revert to normal. The results suggest that the decrease in the quantity and quality of mucus secretion observed with omeprazole is a transient phenomenon, secondary to the sustained acid suppression induced by the drug and clinically irrelevant.

Adult↗
PubMed1990

Weakening effect of famotidine but not of nizatidine on the mucus-bicarbonate barrier of the human stomach.

Twenty outpatients with various duodenal disorders but endoscopically normal gastric mucosa were randomly treated for 4 weeks with either nizatidine (300 mg h.s.) or famotidine (40 mg h.s.). Before and after treatment quantitative and qualitative evaluations of gastric mucus secretion as well as measurement of gastric bicarbonate output were performed. No changes in the mucus-bicarbonate barrier were observed after nizatidine treatment. In contrast, famotidine was found to impair the quality of mucus, thus weakening the mucosal defences against re-ulceration after treatment withdrawal.

Adult↗
PubMed1990

[Antiemetic properties of levo-sulpiride].

Levo-sulpiride is a substituted benzamide with antiemetic activity 3-8 times more potent than the racemic form and the d-isomer. Its mode of action is partially central (inhibition of dopaminergic receptors at the trigger zone for vomiting) and partially peripheral (normalization of motor activity of stomach and gall-bladder). The drug was found effective in the prevention of chemotherapy-induced and post-operative vomiting as well as in the treatment of nausea and vomiting during hepatic, biliary and gastroduodenal disorders, organic and functional dyspepsia, motion sickness and vertigo. Levo-sulpiride is at least as effective as domperidone, antihistamines and neuroleptic agents. Compared with the latter drugs and with d-sulpiride and the racemus, l-sulpiride is much better tolerated. Drowsiness is reported only at high doses, and no clinical signs of hyperprolactinaemia are observed, even after prolonged treatment.

Chemical Phenomena↗
PubMed1989

Comparison of sucralfate and ranitidine in the treatment of chronic nonerosive gastritis. A randomized, multicenter trial.

In a randomized trial involving 20 Italian centers, the effectiveness of 1 g sucralfate three times a day and 150 mg ranitidine twice a day in the treatment of chronic gastritis was assessed and compared. Five hundred outpatients with dyspeptic symptoms and endoscopic evidence of chronic nonerosive gastritis were randomly assigned to either treatment for a period of eight weeks. Endoscopic scores were determined at the beginning and at the end of the study. The severity of dyspeptic symptoms was assessed at Weeks 0, 2, 4, 6, and 8. Four hundred seventy-three patients completed the study. In 331 cases, biopsies were taken during endoscopy, and a histologic evaluation was also performed, according to Whitehead's criteria. Sucralfate was significantly more effective than ranitidine in inducing healing or improvement of both endoscopic (p less than 0.02) and histologic (p less than 0.001) features. At the end of the study, 77.6 percent of the patients in the sucralfate group and 79.4 percent in the ranitidine group were symptom free. Ranitidine was significantly more efficacious at releiving pain during the first four weeks of therapy. Mild side effects were reported by 4.9 percent of patients treated with sucralfate and by 3.6 percent of patients treated with ranitidine. Treatment was withdrawn in one patient treated with sucralfate because of nausea. In conclusion, sucralfate appears significantly superior to ranitidine in improving endoscopic and histologic aspects of chronic nonerosive gastritis. The symptomatic activity of the two drugs is similar, although more rapid relief is obtained with ranitidine.

Chronic Disease↗
PubMed1989

Effects of cimetropium bromide on gastrointestinal transit time in patients with irritable bowel syndrome.

Cimetropium bromide is a new antimuscarinic compound with strong antispasmodic activity. The aim of this study was to evaluate the effects of oral cimetropium bromide on total gut transit time in patients with irritable bowel syndrome. Forty patients, divided according to their initial total gastrointestinal transit times and presenting symptoms, were treated with cimetropium bromide 50 mg t.d.s. or placebo for 1 month according to a double-blind, parallel group design. Before and after treatment all subjects ingested 24 radio-opaque markers. The total intestinal transit time was determined by evaluating the rate of disappearance of markers from plain X-ray films of the abdomen taken every 24 h for 4 days. Pain and bowel habits were also monitored. Seven patients did not complete the study. Cimetropium bromide significantly (P less than 0.01) shortened the whole gut transit time in patients with prolonged transit time (80.8 +/- 4.0 h before vs 60.8 +/- 6.7 h after treatment) and improved the global clinical condition significantly compared with placebo (P = 0.029). In patients with a short total intestinal transit time, cimetropium bromide had no effect on whole gut transit time and did not significantly improve symptoms. The results of this study indicate that oral cimetropium bromide is effective both objectively and subjectively in a subgroup of irritable bowel syndrome patients with constipation.

Adult↗