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Biomedical subjects

S Gustavsson

Publications and source records attributed to S Gustavsson.

At least 91 records · Page 5Linked to original sources
PubMed1984

Cholecystectomy as a risk factor for gastric cancer. A cohort study.

Epidemiological findings suggest that gallstone disease and some frequent human cancers share common risk factors. In the present historical prospective cohort study, comprising 16,773 patients who had undergone cholecystectomy 12-15 years previously, the risk of developing gastric cancer was investigated. The total number of observed gastric cancers (89) was very close to the expected number (88), giving a relative risk (RR) of 1.01. A significantly increased risk (P less than 0.01; RR = 2.67) of developing gastric cancer was found during the first year after cholecystectomy, and this increase was judged to be due to cancers that were present but overlooked at the time of cholecystectomy. Subgrouping according to age at surgery revealed a tendency towards a lower risk in patients operated on before the age of 70 years. It is concluded that our data do not support the hypothesis that there are common risk factors for gallstones and cancer, and cholecystectomy does not seem to be associated with an increased risk of gastric cancer within 15 years after this operation.

Adult↗
PubMed1984

Cholecystectomy and the incidence of breast cancer: a cohort study.

A cohort comprising 11678 women who had undergone cholecystectomy in the period 1964 through 1967 for a benign gallbladder disease was investigated. They represented almost a total ascertainment from a defined geographic area. Follow-up during 11-14 completed years of observation revealed a total of 202 breast cancer cases after the cholecystectomy. This number was close to the expected incidence of 199.1 (relative risk 1.0). Further analysis of the risk in relation to duration of observation and age at operation did not reveal any trend or subgroup with a significantly increased or decreased risk. It was concluded that despite the many epidemiologic observations indicating that in Western Countries dietary habits are particularly important determinants of the high incidence of both gallstone disease and breast cancer, our results contradict the idea that the diseases share common aetiologic factors.

Adult↗
PubMed1984

Evidence for a propulsive function of the migrating myoelectric complex in rats.

In order to investigate the relation between myoelectric activity and the transport of small bowel luminal contents, recordings of migrating myoelectrical complexes (MMCs) were combined with studies of the propulsion of a bile-excreted radioactive test substance. At laparotomy, rats were provided with three pairs of bipolar electrodes, sewn to the seromuscular layer of the small bowel 15, 30 and 45 cm distal to the pylorus. After recovery for 1 week MMCs were recorded with the animal fasted for 18 h and in light barbiturate anesthesia. Concurrently, the bile-excreted radiopharmaceutic, 99mTc-Solco-HIDA, was infused intravenously. At the end of the experiment the rats were sacrificed and the distribution of 99mTc activity was recorded from the excised bowel specimen. In 12 animals with a typical MMC activity recurring every 20 min, the small bowel radioactivity was distributed into discrete portions, separated by fairly long empty segments. In 6 animals the experiments were terminated when an MMC activity front had reached one of the electrodes and in all, a portion of radioactivity was found to be located immediately distal to the position of that particular electrode. 6 control animals were killed when about 10 min had elapsed since the MMC front passed one of the electrode sites. In all these cases the electrode position was found to correspond to empty bowel segments. These data obtained from animals with permanent electrodes but an otherwise intact small bowel strongly support the notion that MMCs result in propulsion of luminal contents.

Animals↗
PubMed1984

Effect of surgical trauma on plasma insulin and somatostatin in response to glucose.

The role of somatostatin for the suppression of insulin release in the early post-traumatic phase was investigated by measurement of somatostatin-like immunoreactivity in plasma during an intravenous glucose tolerance test. In accordance with previous findings the increase of insulin in response to glucose was significantly (p less than 0.001) reduced 2 hours after laparotomy as compared to control subjects. Simultaneously plasma somatostatin was decreased significantly (p less than 0.05). The present data with hormone determinations in peripheral blood does not support the hypothesis that somatostatin, a potent inhibitor of insulin release, mediates the insulin suppression in the early trauma phase.

Adult↗
PubMed1984

The clinical diagnosis of gastritis. II. Aspects of current therapy and drug consumption.

Patients with a clinical diagnosis of 'gastritis' or non-ulcer dyspepsia were studied as to the extent and pattern of drugs prescribed from October 1978 through September 1981. This was permitted by the Diagnosis and Therapy Survey, an ongoing nationwide sample study, covering all outpatient care in Sweden. In 98% of the consultations a drug was considered to be indicated. Antacids were prescribed in 76%, an anticholinergic drug in 40%, and a histamine-H2-receptor antagonist (cimetidine) in 3%. The latter figure seemed to increase during the 3-year study period, concomitant with a decrease in the prescription rate of anticholinergic drugs. Gastritis was the major indication not only for antacids and anticholinergic drugs but also for cimetidine, accounting for 35% of all cimetidine prescriptions. Total sales of these drugs in 1981 amounted to about SKR 150 million. Antacids comprised 57%, anticholinergic/spasmolytics 22%, and cimetidine 21% of this amount. The extensive drug use is remarkable considering the lack of convincing data from randomized controlled clinical trials supporting a therapeutic effect of any drug regimen in gastritis. More such trials in well-defined patient groups are therefore greatly needed.

Antacids↗
PubMed1984

The clinical diagnosis of 'gastritis'. Aspects of demographic epidemiology and health care consumption based on a nationwide sample survey.

The health care resources required by patients clinically considered to have gastritis were studied during a 3-year period. The assessment was based on data from a nationwide sample study covering all outpatient care in Sweden. Gastritis, the fourth commonest diagnosis in general practice, accounted for 2% of all outpatient consultations and for 31% of those for gastroenterological disorders. The estimated minimal number of annual consultations for gastritis was 4500 per 100,000 inhabitants. Seventy-two per cent of the patients with gastritis had previously sought medical advice for similar symptoms. Our results indicate that the patient group traditionally denoted as gastritis constitutes a major health care problem in our community, which should be met by a thorough epidemiological, clinical, and laboratory characterization.

Adolescent↗
PubMed1983

Rapid healing of duodenal ulcers with omeprazole: double-blind dose-comparative trial.

In a double-blind, dose-comparative trial, 32 patients with duodenal ulcer were assigned to receive either 20 mg/day or 60 mg/day omeprazole for 4 weeks. The 2-week healing frequency of 100% in the 60 mg/day group was significantly higher than that in the 20 mg/day group (63%). After 4 weeks all ulcers but one in the 20 mg/day group were healed (93% healing frequency). In both groups transient and mostly slight rises in serum alanine aminotransferase levels were observed (total 10 patients). One patient in the 20 mg/day group was withdrawn because of a pronounced rise in serum alanine aminotransferase on day 8. The reason for these liver reactions is not clear, but exclusion of a causal relation with omeprazole treatment must precede further clinical evaluation of this drug.

Alanine Transaminase↗
PubMed1983

Effects of a fatty meal on small bowel propulsion in intact and vagotomized rats.

The mechanisms by which a fatty meal alters small bowel motility was studied in rats. The fatty meal (3 ml soya bean emulsion) was infused via a permanent gastric catheter and, simultaneously, a bile-excreted radiopharmaceutic, via a central venous catheter. After infusion for 1 h the radioactivity along the small bowel was measured from the excised bowel specimen. In fasting animals an 'interdigestive' pattern was found, characterized by the distribution of small bowel contents in well-separated portions. After administration of the fat meal, a different ('postprandial') type of transit was found, characterized by a continuous distribution of radioactivity along the small bowel. In vagotomized animals the chosen fat meal did not induce a postprandial pattern but instead the small bowel retained its interdigestive transit mode. However, in intact animals pretreated with atropine or naloxone, the fatty meal intragastrically resulted in an ordinary postprandial transit pattern. Thus, the effect of the surgical vagotomy seems to be mediated by interruption of noncholinergic, nonenkephalinergic neurons.

Animals↗
PubMed1983

Comparative randomized, double-blind study of oxmetidine versus cimetidine for short-term treatment of duodenal and prepyloric ulceration.

101 patients with endoscopically verified duodenal or prepyloric ulcerations were treated in a 4- to 8-week double-blind randomized trial with oxmetidine 400 mg twice daily (51 patients) or cimetidine 1 g daily (50 patients). Both groups had free access to antacid tablets for symptomatic relief. There were no significant differences between the two treatment alternatives with regard to ulcer healing, relief of ulcer pain, or antacid consumption. The ulcer healing rate after 4 weeks of treatment was 80% in the oxmetidine group and 74% in the cimetidine group and, after 8 weeks, 92% and 86%, respectively. The differences in healing rate at 4 and 8 weeks and the corresponding 95% confidence limits were 6 +/- 16% and 4 +/- 13%, respectively. Both duodenal and prepyloric ulcerations healed to the same extent in the two regimens.

Adult↗
PubMed1983

Effect of feeding on the pattern of small bowel transit in the rat.

The effect of feeding on the small bowel transit pattern was studied in rats provided with a central venous catheter and a permanent gastric catheter. Solutions of glucose, amino acids or lipids were administered via the gastric catheter for 20 minutes (2 or 10 ml X h-1), while 99Tcm-Solco-HIDA, a bile-excreted radiopharmaceutic, was infused intravenously for 1, 3 or 5 hours. At the end of the intravenous infusion, the gastrointestinal tract was excised and the radioactivity along the specimen was measured. In rats given no gastric feeding, the transit of small bowel contents occurred in well separated portions and the gut segments between the portions were free from radioactivity. With gastric feeding at the higher rate, examination of the small bowel contents after 1 hour showed continuous distribution along the gut, without apparent peaks or empty regions. When examined at 3 and at 5 hours, the small bowel seemed to have resumed its interdigestive pattern. The transit of chyme in the early postprandial period thus occurs in a manner distinctly different from the interdigestive transit pattern. The observations agree closely with electromyographic studies showing postprandial elimination of cyclic recurring activity.

Amino Acids↗
PubMed1983

Colorectal cancer after cholecystectomy: absence of risk increase within 11-14 years.

The importance of cholecystectomy as a risk factor for colorectal cancer was analyzed in an historical cohort study covering 16,773 cases during 11-14 years completed after operation. The observed number of colorectal cancers (130) was lower than the expected 153.5 [relative risk (RR) = 0.85]. For cancer of the colon, the observed number was 87, which was near the 91 expected (RR = 0.95). A significantly increased risk (p less than 0.05; RR = 2.86) was found for cancer of the colon only during the first year after cholecystectomy, and this was judged to be due to cancers present but overlooked at the time of cholecystectomy. The incidence of rectal cancer was significantly decreased (RR = 0.69; p less than 0.05), with 43 observed versus 62.4 expected cases. The distribution of right-sided versus left-sided cancers within the cohort did not differ significantly from that in the general population. Our results do not as yet support previous epidemiologic observations of an increased risk of colorectal cancer after cholecystectomy.

Adult↗
PubMed1982

Cimetidine or propantheline combined with antacid therapy for short-term treatment of duodenal ulcer.

Seventy-one patients with duodenal ulcer disease completed a 3- to 6-week controlled randomized trial in which cimetidine (1 g daily) was compared with an optimally effective dose of propantheline. Both groups had free access to an antacid suspension. There were no significant differences between the groups concerning ulcer healing, relief of ulcer symptoms, antacid consumption, or patient compliance. After 3 weeks of treatment, endoscopic examination revealed complete ulcer healing in 63% of the cimetidine and 47% of the propantheline treated patients. The corresponding figures after 6 weeks were 94% and 86%, respectively. After 12 weeks, ulcer recurrence was confirmed in 26% of the cimetidine- and 23% of the propantheline-treated patients. Except for the absence of anticholinergic adverse reactions, no significant advantages could be confirmed for combined cimetidine and antacid treatment.

Adult↗