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Biomedical subjects

P Rampal

Publications and source records attributed to P Rampal.

At least 73 records · Page 4Linked to original sources
PubMed1995

Pain and quality of life in patients with acute duodenal ulcer treated with ranitidine.

BACKGROUND: The various components of pain and quality of life in duodenal ulcer patients receiving antisecretory drugs have not been studied to date. METHODS: Ninety-five patients with epigastric pain and duodenal ulcer at endoscopy completed this prospective, multicenter, open-study. All were treated with effervescent ranitidine 300 mg daily for 4 weeks. The following parameters were assessed: (a) disappearance of duodenal ulcer pain by self-evaluation and on a weekly visual analogue scale (VAS) from 0 to 100; (b) evolution of sensory and affective components of ulcer pain by the Validated French Version of the McGill Pain Questionnaire (Questionnaire Douleur de Saint-Antoine, QDSA); (c) quality of life by the Nottingham Health Profile (NHP) which includes six criteria: pain, mobility, energy, emotions, sleep and social isolation. RESULTS: Forty-nine, 66 and 87% of the patients were pain-free during the day-time after 7, 14 and 28 days, respectively. Corresponding figures for the night-time were 80%, 88% and 97% respectively. Median time to disappearance of ulcer pain was 8 days. VAS self-assessment showed a significant decrease each week throughout the treatment period (P = 0.001). Sensory and affective QDSA scores were significantly improved after the second day and at each assessment during the 28 days of treatment (P = 0.001). Physical as well as affective aspects of quality of life were significantly improved after 28 days for each of the six criteria explored (P = 0.001). The duodenal ulcer healing rate was 86% after 4 weeks of treatment. CONCLUSIONS: Using complementary scales measuring different aspects of ulcer pain, sensory and affective components improved significantly from the second day of treatment with ranitidine 300 mg. A significant improvement in quality of life is observed after a 4-week treatment. QDSA and NHP appear to be useful evaluation tools of duodenal ulcer pain and quality of life.

Adolescent↗
PubMed1995

Effect of enprostil and cimetidine on ethanol-induced damage to intestinal epithelial cell lines IRD 98 and IEC 17.

In addition to their inhibitory action on gastric acid secretion, prostaglandins may exert part of their protective effect on the gastrointestinal mucosa by specifically maintaining the cellular integrity of the intestinal epithelium. This in vitro study investigated the cytoprotective effect conferred on intestinal epithelial cell lines IRD 98 and IEC 17 against ethanol injury by the synthetic prostaglandin enprostil and compared effects with those of the histamine H2-receptor blocker cimetidine. Exposure to 3% ethanol (652 mM) reduced cell viability and increased the cAMP and membrane fluidity of both cell lines. Our results demonstrate that: (i) enprostil exerts a significant cytoprotective effect against damage by ethanol; (ii) cimetidine has no cytoprotective effect; (iii) IRD 98 cells are more sensitive to enprostil than IEC 17 cells.

Animals↗
PubMed1995

Prevention and treatment of traveler's diarrhea: a clinical pharmacological approach.

Diarrhea represents a major health problem for travelers to developing countries. Although the syndrome is usually self-limited and recovery occurs in the majority of cases without any specific form of therapy, there is a need for safe and effective ways of preventing and treating it. Since the syndrome is most often caused by an infection acquired by ingesting fecally contaminated food or beverages, precautions regarding dietary habits remain the cornerstone of prophylaxis, but dietary self-restrictions do not always translate to reduced rates of diarrheal illness. Administration of probiotics (e.g. lactobacilli or Saccharomyces boulardii) and immunoprophylaxis with the newer oral cholera vaccines have been tried with promising results. Antimicrobials remain, however, the most successful form of prophylaxis, being effective in up to 90% of travelers. For those with impaired health who will take prophylaxis, systemic agents with proved efficacy should be recommended. For other otherwise healthy persons, poorly absorbed agents are preferable in order to avoid the serious, albeit rare, toxicity of systemic drugs. The key factor in the management of acute watery traveler's diarrhea, particularly in infants and young children, is the restoration of water and electrolyte balance. This does not reduce the duration of the illness but will limit dehydration and prevent acidosis. Many patients will require no additional therapy, whereas some will need pharmacologic treatment to shorten the duration of diarrhea or to relieve the accompanying symptoms, like abdominal discomfort, nausea and vomiting. A typical 3- to 5-day illness can be reduced to approximately 1 day by trimethoprim-sulfamethoxazole (TMP-SMX) combination. Some other systemic antimicrobials have been successfully used but, during the last few years, the 4-fluoroquinolone drugs have received considerable attention and have been shown to be highly effective in reducing the duration of traveler's diarrhea. These antimicrobials may become the best option for adults. The safest choice remains the use of poorly absorbed antimicrobials. Unfortunately, however, only a few compounds (i.e. bicozamycin and furazolidone) have been specifically tested in the therapy of traveler's diarrhea. Others (e.g. nifuroxazide or rifaximin), which have been found effective in various homeland forms of infective diarrhea deserve to be evaluated in specifically designed clinical trials. Persons visiting developing countries where the risk of traveler's diarrhea is high should be recommended to bring an antidiarrheal compound or bismuth subsalycilate, if available, and an antibacterial agent. For infants, children and the elderly, in whom dehydration may occur rapidly and be particularly dangerous, oral rehydration solutions are indicated.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗
PubMed1995

Stimulation of HT29-D4 cell growth by excretory/secretory products of the parasite nematode Trichostrongylus colubriformis.

The presence of the nematode parasite Trichostrongylus colubriformis in the small intestine is associated with an increase in epithelial renewal. To assess the possible role of excretory/secretory products from the worm on cell proliferation, adult Trichostrongylus colubriformis were incubated in vitro in Dulbecco's Modified Eagle's Medium for 24 h and the conditioned medium was added to the culture medium of the transformed epithelial cell line HT29-D4. A stimulation of the HT29-D4 cell growth was ascertained at concentrations of 0.25-1.0 micrograms protein/ml using counts of cell numbers, the MTT method and incorporation of tritiated thymidine. An increased incorporation of tritiated thymidine was also observed with the excretory/secretory products from T. colubriformis fourth stage larvae at 1.0 microgram/ml. Dialysis of the medium conditioned by the worms indicated that the molecular weight of the factor is greater than 8000 Daltons in size. Heat treatment, acid hydrolysis and precipitation by trichloracetic acid of the conditioned medium resulted in the disappearance of the proliferative effect while treatment with trypsin partially depleted the stimulative activity. These results suggest that T. colubriformis produce some protein factor which could increase the epithelial regeneration in the host small intestine.

Animals↗
PubMed1994

Regulation of cholesterol uptake in the rat intestinal cell line.

A new model to study cholesterol absorption in the rat intestinal cells is described. Rat intestine epithelial cells IRD98 were incubated with mixed micelles containing bile acid, phospholipid, cholesterol or its nonabsorbable analogue, sitosterol, and trace amounts of [3H]cholesterol or [14C]sitosterol. Cholesterol and sitosterol uptake was then determined following lipid extraction; specific cholesterol uptake was determined as the difference between cholesterol and sitosterol uptake. Cholesterol, but not sitosterol, uptake was time- and dose-dependent and saturable. Loading of cells with non-lipoprotein cholesterol reduced cholesterol, but not sitosterol, uptake in a dose-dependent manner. In contrast, treatment of cells with an inhibitor of cholesterol synthesis, lovastatin, stimulated cholesterol, but not sitosterol, uptake in a dose-dependent manner. Treatment of cells with palmitic, caproic and oleic acids up-regulated specific cholesterol uptake, while linoleic and stearic acids had an opposite effect. None of the fatty acids affected sitosterol uptake.

Animals↗
PubMed1994

Saccharomyces boulardii inhibits secretagogue-mediated adenosine 3',5'-cyclic monophosphate induction in intestinal cells.

BACKGROUND/AIMS: The yeast Saccharomyces boulardii inhibits the secretion induced by cholera toxin (CT) in rat jejunum. The present study was aimed at unraveling the mechanism by which S. boulardii protects intestinal cells against CT. METHODS: CT-induced adenosine 3',5'-cyclic monophosphate (cAMP) levels were measured by radioimmunoassay in intestinal epithelial cells IEC-6 or HT29-D4 cells exposed to whole yeast or to culture medium conditioned by S. boulardii (Sb-conditioned medium). RESULTS: Sb-conditioned medium significantly reduced CT-induced cAMP levels in IEC-6 cells. This effect was eliminated by heat treatment, trypsin hydrolysis, and trichloroacetic acid precipitation of Sb-conditioned medium. When conditioned medium was fractionated on polyacrylamide gel under nondenaturing conditions, neutralizing activity was shown to be associated with a 120-kilodalton protein. The neutralizing activity was not attributable to proteolytic activity against CT. Sb-conditioned medium reduced the amount of cAMP induced by CT as well as Escherichia coli thermolabile toxin or forskolin in HT29-D4 cells. The modulation of secretagogue-induced cAMP by Sb-conditioned medium did not occur in the presence of pertussis toxin. CONCLUSIONS: These results suggest that the neutralization of CT by S. boulardii is mediated by a specific yeast protein and involves a receptor that is negatively coupled to adenylate cyclase.

Animals↗
PubMed1994

A quality of life study in five hundred and eighty-one duodenal ulcer patients. Maintenance versus intermittent treatment with nizatidine.

Quality of life (QoL) is commonly assessed for evaluating the process and outcome of treatment but has not been studied in duodenal ulcer (DU) disease. The recently developed and validated Quality of Life in Duodenal Ulcer Patients (QLDUP) questionnaire allowed the study of various dimensions according to treatment regimens. This study was conducted to compare QoL over a one-year follow-up period in DU patients randomized to two treatment regimens: maintenance versus intermittent (no maintenance) treatment with nizatidine. A total of 581 patients with endoscopic evidence of DU healing were randomly allocated to receive either nizatidine 150 mg/day for one year (Group A) or intermittent treatment (Group B). In both groups, symptomatic relapses were treated with nizatidine 300 mg/day for 6 weeks. The QLDUP questionnaire, which provides a QoL profile from 54 items divided up into 15 dimensions, was completed by all patients at entry and again at the time of a visit every 2 months for one year. The one-year symptomatic relapse rates were 8.0% and 33.5% in Group A and Group B, respectively (p < 0.001). The intent-to-treat analysis showed that patients in Group A had better QoL scores than those in Group B as regards 8 QoL dimensions, including ulcer-specific and non-specific dimensions. Differences between treatments were significant after 4 months, and this was sustained until the one-year assessment. The overall gain in QoL was significantly greater in Group A than in Group B with respect to 11 QoL dimensions. In conclusion, maintenance treatment with nizatidine for DU improved QoL to a larger extent than when intermittent therapy was used.

Adult↗
PubMed1993

Cholesterol uptake in the human intestine. Hypo- and hyperresponsiveness.

Cholesterol uptake was studied at the small intestine biopsies taken from patients without intestinal malfunction. Three distinct groups of patients were described: those with low (146 +/- 19) nmol/mm2 per 2 h), medium (455 +/- 18 nmol/mm2 per 2 h) and high (833 +/- 24 nmol/mm2 per 2 h) rates of cholesterol uptake. Positive correlation between cholesterol uptake and intestinal cholesterol synthesis was observed in the last two groups.

Acetates↗
PubMed1993

Lipid metabolism by the intestinal mucosa in malnourished subjects following enteral nutrition supplemented with omega3 fatty acids.

UNLABELLED: Chronic malnutrition results in severe metabolic imbalance in man as the body modifies its modes of regulation of different nutrients, and in particular lipids. This study of the modifications in lipid metabolism induced by 15 days of enteral renutrition include: 12 malnourished patients (global nutritional deficit (GND) <20%) were given a cyclical enteral diet for 15 days under two conditions: ternary diet (Sondalis) or a similar diet whose lipid concentration was enriched by 5.3 g omega3 fatty acid per day. On Day 0 and Day 15, the serum lipid values were assayed and duodenal biopsies were taken to measure HMG-CoA reductase and (14)C acetate incorporation in the various classes of lipids. After 15 days of refeeding, the GND had been corrected by an average of 27% and HMG-CoA reductase activity had increased by 37% (60.2 +/- 7.46 vs 82.88 +/- 14.8 pmol/min/mg protein; p < 0.05). In 7 12 patients, the serum cholesterol values had increased (p < 0.01). No difference was observed in synthesis of FA, DG or cholesterol. Synthesis of phosphatidylcholines (PC) and phosphatidylglycerols (PG) was reduced by 12% and 23% respectively. Triglyceride synthesis (TG) increased by 20% (p < 0.05). The only difference between the two diets was in TG synthesis in organ-specific culture, which was increased only by the standard diet. IN CONCLUSION: (i) refeeding is accompanied by an increase in intestinal HMG-CoA reductase activity, a decrease in PC and PG synthesis, and an increase in TG synthesis; (ii) a diet enriched in omega3 FA increases TG synthesis less than the standard diet.

Journal Article↗
PubMed1993

[Effect of interleukin 2 on the proliferation of two intestinal cell lines and on the expression of TGF-beta gene and JUN/FOS oncogenes].

Effect of interleukin 2 (IL-2) on the proliferative rate of a human colon adenocarcinoma line (HT-29 D4) and of an untransformed rat intestinal cell clone (IEC-6) was studied in vitro. IL-2 had an antiproliferative effect which was cytotoxic-free: interleukin 2 did not induce any significant cell death, apoptosis or change in cellular protein content. Northern blot characterization of cellular mRNA revealed that interleukin 2 enhances the expression of JUN, FOS and TGF beta which are known to be involved in antiproliferative processes. Kinetic analyses suggest that the aforedescribed biological effect is mediated by the AP1 complex (JUN/FOS) when dealing with rapid inhibition (HT-29 D4 and IEC-6) and by an autocrin TGF beta loop when dealing with slow inhibition (IEC-6).

Adenocarcinoma↗
PubMed1993

[Isolated smooth muscle cells of the human colon. Cytophysiological study].

Gross normal specimens of human distal colon were obtained at operation for cancer. Smooth muscle cells were separated from internal and external layers of the muscularis. They were dissociated by digestion with collagenase, isolated and concentrated by successive centrifugations. Colonic smooth muscle cell contraction was measured using various concentrations of carbamylcholine (10(-9) to 10(-4) M); relaxation was tested using atropine (10(-9) to 10(-4) M) on colonic smooth muscle cells pre-contracted by carbamylcholine. Compared with previous descriptions, human smooth muscle cells were smaller than in other species with an enlarged distribution of cell size (30 microns to 150 microns in length). Significant dose-response curves were obtained for both carbamylcholine and atropine. However, 3 original points characterized human colonic smooth muscle cells: a) the cells isolated from the internal layer were significantly more sensitive than those isolated from the external layer (10(-9) M vs 10(-7) M); b) for the muscle cells isolated from both the internal and external layers, small colonic smooth muscle cells were significantly more sensitive. On the other hand, these cells were shown to be located near conjunctive septae, and intramural plexuses; c) analysis of contraction curves demonstrated a more efficient response for colonic smooth muscle cells of the internal layer than for those of the external layer of the muscularis.

Atropine↗