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Biomedical subjects

W Rubin

Publications and source records attributed to W Rubin.

At least 19 recordsLinked to original sources
PubMed2000

[Neurohumoral mechanisms in pathophysiology of chronic heart failure].

Pathogenic mechanisms of chronic systolic heart failure are constantly of great interest. In recent years the neurohumoral theory of heart failure has gained attraction. According to this theory, neurohumoral mechanisms play the main role in the pathogenesis of heart failure, especially in its progression. These mechanisms can be divided into 2 categories: vasoconstrictive, mitogenic and antinatriuretic on the one hand and vasodilative, antimitogenic and natriuretic on the other one. The former consists of sympathetic nervous system, renin-angiotensin-aldosterone system, vasopressin, endothelin, cytokines. The latter comprises natriuretic peptides, prostaglandins and nitric oxide. Undoubtedly unfavourable roles of sympathetic system and renin-angiotensin-aldosteron have been shown in the progression of heart failure. Data are being also gathered confirming harmful effects of endothelin and cytokines and possibly of neuropeptide Y and vasopressine. Extensive data exist that demonstrate beneficial influence of natriuretic peptide on heart failure. The roles of nitric oxide as well as recently discovered adrenomedullin and medullipin are far from clear.

Chronic Disease↗
PubMed1999

Inhibition of gastric secretion relieves diarrhea and postprandial urgency associated with irritable bowel syndrome or functional diarrhea.

Five patients with gastroesophageal reflux disease (GERD), who also had chronic functional diarrhea and postprandial urgency, unexpectedly noted rapid relief of their diarrhea and urgency when they took lansoprazole for their heartburn. To determine if this surprising result was not fortuitous, all 20 patients seen during the next six months for chronic diarrhea and postprandial urgency due to irritable bowel syndrome (IBS) or functional diarrhea were treated with inhibitors of gastric secretion: 14 with proton-pump inhibitors and 6 with H2 blockers. All patients had rapid, marked improvement. Usually within three days, their symptoms abated and they usually had one to three formed stools per day. Relief continued during the one to six months they were followed on therapy. Five patients stopped therapy, had recurrent diarrhea, and rapid relief upon resuming therapy. Thus, inhibition of gastric secretion effectively controls the diarrhea and postprandial urgency associated with IBS or functional diarrhea, probably by diminishing the gastrocolic or gastroenteric reflex.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1999

Nutrition, biochemistry, and tinnitus.

Biochemical mechanisms are a significant factor in neurootological problems. Investigation of biochemical causes of neurootological problems, such as tinnitus, are warranted and can be cost-effective. Dietary, nutritional, chemical, hormonal, immunological, and stress factors are involved directly in neurootological problems and must be evaluated and considered in designing the treatment regimen for patients complaining of tinnitus.

Humans↗
PubMed1996

The infectious etiology of peptic ulcer disease. Diagnosis and implications for therapy.

During the past decade, peptic ulcer disease has become recognized as multifactorial in etiology, with a major component thought to be infection of the gastric mucosa with a spiral-shaped bacterium known as Helicobacter pylori. This organism has been found to cause most cases of chronic gastritis and is clearly pathogenic in most cases of duodenal and gastric ulceration. Biologic characteristics, epidemiology, and methods of detection (invasive and noninvasive) of H. pylori are discussed from a clinical perspective. Finally, eradication of H. pylori infection is difficult because of bacterial resistance and patient noncompliance.

Helicobacter Infections↗
PubMed1996

Pancreatitis. Evaluation and treatment.

Acute and chronic pancreatitis present challenging problems for the physician. In acute pancreatitis, initial efforts should be directed toward supporting the patient hemodynamically. Recognition and early treatment of complications such as shock, renal failure, respiratory failure, hypocalcemia, abscess, hemorrhage, or unremitting symptoms caused by an impacted stone in the common bile duct are necessary. The cause of the pancreatitis must be identified, possibly for acute therapy, but certainly to prevent recurrences and progression of disease. In chronic pancreatitis, insufficiencies of pancreatic function must be identified and consequent malabsorption and diabetes treated appropriately. The major challenge is the relief of chronic pain. It is hoped that this can be accomplished medically, but in carefully selected cases, specific types of surgery may be required.

Acute Disease↗
PubMed1995

The effects of short-term lansoprazole therapy on Helicobacter pylori infection and antral gastritis in duodenal ulcer patients.

BACKGROUND/AIMS: Lansoprazole is a new potent proton pump inhibitor that exhibits activity against Helicobacter pylori in vitro. This study endeavored to determine the effects of 4 wk of lansoprazole therapy upon H. pylori infection and antral gastritis in duodenal ulcer patients and to determine the relationship of the gastritis with Helicobacter infection and with ulcer activity. METHODS: Satisfactory antral biopsies were obtained from 119 duodenal ulcer patients before and after 4 wk of therapy with lansoprazole, ranitidine, or placebo. Sections were scored blindly for degree of active and chronic inflammation and extent of H. pylori infection. RESULTS: Four weeks of lansoprazole (30 mg daily) or ranitidine (300 mg daily) therapy produced a significant decrease in H. pylori infection. The reduction of H. pylori infection, but not ulcer healing per se, correlated with the decrease in active and chronic antral inflammation. Reduction of H. pylori infection, however, did not improve the good ulcer-healing rates already achieved at 4 wk by potent acid inhibition. CONCLUSIONS: Lansoprazole exhibits activity against H. pylori in vivo. Short-term improvement in antral gastritis is affected by reduction of H. pylori infection but not by ulcer healing.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1994

Atypical forms of inflammatory bowel disease.

Atypical forms of IBD include the microscopic colitides, collagenous and lymphocytic colitis, and two macroscopic colitides, SRUS and diversion colitis. Clinical presentations include chronic, watery diarrhea and intermittant rectal bleeding. Constitutional symptoms are typically absent; laboratory data are often nonspecific. Colonoscopic evaluation and mucosal biopsy are essential in establishing these diagnoses and excluding more classic forms of IBD (i.e., Crohn's disease or idiopathic ulcerative colitis). Prognosis and response to treatment are variable; potential therapeutic options include dietary manipulations, topical or systemic anti-inflammatory agents, and, in refractory cases, surgical intervention.

Colitis↗
PubMed1993

Who's ethical?

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Education, Medical↗
PubMed1991

Medical treatment of peptic ulcer disease.

Our understanding of PUD and its treatment has improved dramatically during the past 15 years. During this time, many new effective drugs have been approved by the FDA, and possibly even more potent and effective therapies are now being evaluated. The H2-blockers, sucralfate, and antacids heal over 90% of duodenal ulcers in 6 to 8 weeks, and H2-blockers heal about 80% of gastric ulcers by 8 weeks and over 90% by 12 weeks. The new, more potent pump blockers (omeprazole) promise to be even more effective drugs, even for the healing of patients who are taking NSAIDS. However, the potential hazards of marked, long-term acid suppression must still be evaluated. Maintenance therapy with H2-blockers or sucralfate, ideally used for patients who would otherwise have frequent symptomatic recurrences of duodenal ulcer disease or who have had complications, reduces the relapses, especially symptomatic relapses. Maintenance therapy with H2-blockers also seems to reduce the recurrences of GUD, but this use has not yet received FDA approval. Elimination of H. pylori infection with antibiotics may prove to reduce recurrent ulcer disease and negate the need for maintenance therapy. Colloidal bismuth subcitrate alone, which suppresses but does not eradicate H. pylori infection, seems to be an effective ulcer drug and may even reduce the rate of early recurrences. Effective ulcer therapy, especially if it prevents recurrent disease, may reduce the complications of PUD, but this expectation has yet to be established. The use of prophylactic cytoprotective prostaglandins (misoprostol) reduces the incidence of NSAID-induced GUD.

Antacids↗
PubMed1991

Practical method of reporting test results in neurotologic disorders.

A more practical method of reporting the neurotologic test results became desirable in the course of preparing case reports. This need grew out of the necessity to organize neurotologic tests results in a simple, easily understandable, nonredundant manner. Tests organized in this manner were vestibular and auditory tests. Vestibular tests included electronystagmography, rotational testing, and posturography. Auditory tests included pure-tone testing, speech testing, impedance testing, and auditory brainstem responses.

Hearing Tests↗
PubMed1990

The dizzy patient: etiologic treatment.

The basis for the vestibular complaint in dizzy patients should be viewed as having an etiology rather than a description of its clinical presentation. Effective treatment of vestibular disorders is based on the stabilization of the vestibular abnormality, to allow for central vestibular compensation. While not all of the etiologies for dizziness have been described, there are effective etiologic treatments available. These fit into categories of neurotransmitters, blood sugar and blood fat control, hormones, minerals, and treatments for autoimmune dizziness.

Autoimmune Diseases↗