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Biomedical subjects

M Guslandi

Publications and source records attributed to M Guslandi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Nitric oxide and inflammatory bowel diseases.

Nitric oxide (NO) production, as detectable by indirect and direct methods, as well as the expression of inducible nitric oxide synthase (iNOS) in the intestinal mucosa appear to be enhanced in active ulcerative colitis and, when in excess, to play a proinflammatory role in the disease. Despite some conflicting data, there is evidence that NO production is also increased in Crohn's disease. Many inflammatory features of inflammatory bowel disease are in keeping with the physiological properties of NO, and toxic megacolon, a complication of chronic colitis characterized by acute colonic dilatation, is associated with an enhanced intestinal synthesis of NO. The drugs currently used in the treatment of inflammatory bowel disease (steroids, salicylates) do not seem to exert substantial effects on intestinal NO synthesis. The possible therapeutic role of selective iNOS inhibitors is still under investigation.

Animals↗
PubMed1998

Outcome of ulcerative colitis after treatment with transdermal nicotine.

OBJECTIVE: Transdermal nicotine appears to be of benefit in the short-term treatment of patients with ulcerative colitis. The aim of this study was to determine its long-term effects. DESIGN: A randomized, comparative study. PATIENTS AND METHODS: Patients with mild to moderate clinical relapses of left-sided ulcerative colitis during maintenance treatment with mesalamine 1 g b.i.d. were allocated to an additional treatment with either transdermal nicotine or prednisone for 5 weeks. The first consecutive 15 patients per group, with clinical and endoscopic signs of remission, were followed up for 6 months, while continuing mesalamine maintenance treatment. RESULTS: Relapses of active colitis were observed in 20% of patients formerly treated with nicotine and in 60% of patients in the prednisone group (P = 0.027). Relapses occurred earlier in the latter group. CONCLUSION: Our results confirm that nicotine is useful in cases of ulcerative colitis with mild or moderate activity and suggest that remissions induced by nicotine may last longer than those obtained with oral corticosteroids.

Administration, Cutaneous↗
PubMed1998

[Dyspepsia: a reappraisal problem].

Dyspepsia is a major public problem. It occurs in 25-40% of the general population negatively affecting the quality of life. 2-3% of the patients visited by the GP and up to 30% of those visited by the gastroenterologist have dyspepsia. Both diagnostic procedure and therapy are expensive. Definition, aetiology and pathogenesis of the disorder are not clear cut. The aim of this review is to outline the main trends in the relevant area of the clinical practice. The authors choose the most comprehensive definition among the thirty of the medical literature. To rule out, the most commonly and frequently wrong opinions risk factors have been examined. The authors distinguished between symptoms of function and organic dyspepsia and those of Irritable Bowel Syndrome and Gastro-Esophageal Reflux Disease, which often overlap and make difficult the management of the patient. The aetiology and pathogenesis have also been discussed, with particular emphasis on Hp. Advantages and drawbacks of different diagnostic approaches have been investigated. An age and symptoms related approach of the cases with dyspepsia is proposed, which allows to manage the patient without the necessity of invasive procedures. It is finally suggested that are cases which can be managed by the GP and others for whom the gastroenterologist intervention is mandatory.

Adult↗
PubMed1997

Brief communication: smoking and duodenal blood flow.

Smoking promotes an increase in both the incidence and the recurrence of duodenal ulcers, but the mechanisms responsible for its adverse effects on the duodenal mucosa are still poorly understood. The aim of the present study was to investigate the effect of chronic cigarette smoking on duodenal blood flow. In 20 dyspeptic patients (10 non-smokers and 10 smokers) with endoscopically normal duodenum, mucosal blood flow was measured in the duodenal bulb by laser Doppler flowmetry during endoscopy. Basal bulbar perfusion was found to be significantly lower (P < 0.05) in smokers. Our results suggest that duodenal blood flow is reduced in heavy smokers. This may promote duodenal damage because of both local ischaemia and the reduced secretion of protective bicarbonate.

Adult↗
PubMed1997

Gastric toxicity of antiplatelet therapy with low-dose aspirin.

Low-dose aspirin is widely employed as antiplatelet therapy for cardiovascular disorders. However, even in the dosages usually employed for that purpose (75 to 325 mg daily), the drug maintains its ability to damage the gastric mucosa by inducing bleeding ulcers and/or erosions. Pharmacological protection is therefore necessary. Specific long term studies with histamine H2 receptor antagonists or sucralfate are lacking, but data from trials on the prevention of gastric damage by other nonsteroidal anti-inflammatory drugs (NSAIDs) are discouraging. Recent preliminary data suggest that misoprostol, in keeping with its ability to protect both gastric and duodenal mucosa from long term NSAID treatment, seems to be effective also against long term low-dose aspirin therapy in this setting.

Aspirin↗
PubMed1996

Pilot trial of nicotine patches as an alternative to corticosteroids in ulcerative colitis.

In ten patients with mild to moderate clinical relapses of ulcerative colitis during treatment with mesalazine (1 g t.i.d.) and with a previous history of poorly tolerated steroid courses, transdermal nicotine (15 mg daily) was added for 4 weeks. Clinical findings were assessed by employing Rachmilewitz's activity index. In 7 of the patients, clinical remission was achieved, the results persisting for up to 3 months after nicotine withdrawal. Endoscopic and histological examination, when performed, confirmed the clinical findings. Nicotine patches may represent a good alternative to steroids in selected patients with mild to moderate relapses of ulcerative colitis. The precise mechanism of action remains unknown.

Administration, Cutaneous↗
PubMed1996

Epidemiological aspects of NSAID gastropathy.

NSAIDs are among the most frequently prescribed drugs worldwide. Unfortunately acute and especially chronic NSAID intake is accompanied by untoward side effects of the digestive system, particularly the gastroduodenal tract. Erosions and ulcers are more common in the stomach, but also the duodenal mucosa can be involved. Elderly patients are the subjects most at risk of developing gastric lesions, which are often asymptomatic. Complications such as bleeding and perforation may suddenly occur, sometimes with a fatal outcome. Epidemiological data and risk factors are reviewed and commented in detail.

Age Factors↗