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At least 181 records · Page 10Linked to original sources

[Treatment of duodenal ulcer with Zantac-ranitidine].

The results from the treatment with the preparation Zantac -Ranitidine of 30 patients with duodenal ulcers are reported. The treatment was carried out with 2 X 150 mg ranitidine daily for 20 days. As early as the second or third day after the initiation of the treatment, the pain disappeared in 96,6 per cent, the sense of heaviness and eructation -- in 100 per cent, pyrosis and palpation pain -- in 96,6 per cent an nausea - in 93,3 per cent. All indices of the gastric secretion (V, BAO, MAO and PAO) were reduced with a statistical significance after 20-day ranitidine treatment, as compared with the initial values. Epithelization (healing) of the ulcer was fibroendoscopically established in 73,3 per cent by 20th day, and by 40th -- in 93,3 per cent. The bigger ulcers were more slowly epithelized . Ranitidine was very well tolerated and gave no adverse effects. Better results, with a statistical significance, were obtained with ranitidine treatment of the duodenal ulcer, both as regards the effect on the subjective symptoms and epithelization of the ulcer as compared with the control group.

Adult↗

[Treatment of peptic ulcer with Alcid V].

The results from Alcid V treatment are reported, carried out in the course of 20 days on 39 patients with duodenal and 20 patients with gastric ulcers. A group of 20 patients with duodenal and 10 with gastric ulcers, treated with placebo served as a control under the conditions of double-blind experiment. The pains completely abated in 84 per cent of the patients with gastric ulcer, the pyrosis in 100 per cent, eructation--in 92.3 per cent and the ulcer--in 68.42 per cent, and in the patients with duodenal ulcers--76.9 per cent, 93.10 per cent, 94.3 per cent and 40.62 per cent respectively. As regards the clinical symptoms of gastric ulcers, very good effect was obtained in 76 per cent and good effect--in 24 per cent; in the cases with duodenal ulcers--70.49 per cent and 15.38 per cent respectively. The discrepancy between the effect on the clinical symptoms and on the ulcers (the changes of the latter being endoscopically determined) between the Alcid V treated patients and the control group with placebo are statistically significant. In both groups the gastric secretion (determined by pentagastrin test) is not substantially changed as compared with the values prior to the treatment. Alcid V in the dose administered and the duration of the treatment induced no adverse effects and no essential changes in the biochemical indices; it was well tolerated and could find its application in the treatment of ulcer disease.

Anti-Ulcer Agents↗

[Trials with the native physiological tube-feeding diet Nutro-Drip after maxillofacial operations].

40 patients, who underwent maxillo-facial surgery, were fed with the native physiological diet Nutro-Drip via nasogastric tubes for 10 days. Due to intolerance in 5% of the patients, the nutrition had to be interrupted. The other patients received 1500-2500 ml Nutro-Drip per 24 h (= 1605--2675 kcal = 6780-11300 J). Transient side effects were: diarrhoe 3,8%; nausea 0,8%; eructation and/or heartburn 1,1%; squeezing of the stomach 1,1%. In these patients nutrition with Nutro-Drip was not interrupted. The mean frequency of defecation was 0,81/day. There were no significant changes in body weight, serum electrolytes, water balance, blood sugar, liver enzymes, serum cholesterol, and acid-base balance during the feeding with Nutro-Drip. Immediately after surgery there was a statistically significant decrease in potassium, protein, and albumin levels in the serum with the tendency to normal values during Nutro-Drip feeding. During the postoperative period the urea content of the serum increased continuously without altering creatinin levels in the serum. Nutro-Drip seems to be very suitable for tube-feeding in patients with normal gastro-intestinal tract.

Adult↗

[Postoperative nutrition of maxillary surgery patients with the instant formula diet].

33 patients, who underwent maxillo-facial surgery, were fed with the instant formula diet Nutricomp F via a nasogastric tube for a mean time of 10 days. According to intolerance tube feeding had to be interrupted in 3 patients. Other side effects of nutrition with Nutricomp F were diarrhea (2,9%), nausea (1,2%), vomiting (1,2%) and eructation (1,2%). The mean frequency of defecation was 0,64/day. Glucose content of the blood, water balance, body weight, serum electrolytes, liver enzymes, acid-base-balance and the protein content of the serum did not change significantly. The postoperative increase of urea content in the serum is believed to be independent from formula diet.

Adolescent↗

Surgical problems with gastroesophageal reflux.

One hundred and fifty-eight patients with gastroesophageal reflux underwent semifundoplication with intraabdominal fixation of the esophagus by suturing the valve to the diaphragm. The immediate functional results were excellent in 156 cases, one patient had recurrent gastroesophageal reflux and another had a sliding hernia. The mean follow-up period of 124 patients was 36 months. In almost all patients gastroesophageal reflux, gas-bloat syndrome and the inability to vomit or eructate were absent. The author describes the conditions necessary for a good anti-reflux technique and compares his technique with those of Nissen, Hill and Belsey.

Esophagus↗

Pharyngeal trauma in cattle.

Four cases of pharyngeal trauma in cattle due to improper administration of oral medications are discussed. These cases presented for suspected gastro-intestinal disorders and anorexia. Physical findings included copious drooling of saliva, pharyngeal pain, extended head and neck, forestomach stasis, fever, dysphagia, and pneumonia. Diagnosis was made by manual examination of the oral cavity or endoscopy. Ancillary diagnostic aids included clinical pathology and radiography. Hemograms were consistent with infection, serum electrolytes were normal. Radiographs in 3 of 4 did reveal significant evidence of retropharyngeal cellulitis. The signs of dysphagia and forestomach dysfunction were explained by either a pain induced inhibition of swallowing and eructation or direct involvement of the vagus nerve itself in the retropharyngeal region. An additional consequence of laryngeal motor dysfunction was aspiration pneumonia. Response to treatment with broad spectrum antibiotics, analgesics and symptomatic supportive care over a 7 to 14 day period was good.

Animals↗

Surface rippling of the lower left flank of the cow: mirror of ruminal motility.

A detailed description is given of 5 types of surface ripples occurring on the ventral part of the lateral abdominal region of the healthy dairy cow. Results of endoruminal palpation and concurrent visual observation of healthy cows which have permanent ruminal fistulae indicate that the more apparent ripples are due to the movements and changes in tension of the underlying cranial and caudal parts of the left longitudinal pillar and the left accessory pillar of the rumen. The ripples occur during both the primary (or mixing) cycle and the secondary (or eructation) cycle of ruminal motility. The cause of the rising and sinking of the left paralumbar fossa is discussed, and a correlation is made between their occurrence and that of the surface rippling. The possible clinical significance of the rippling is considered.

Abdomen↗

[Treatment of upper-abdominal pain in chronic gastritis. Results of therapy with the motility regulating drug Bromopride].

After discussing the aetiological role of the reflux from the duodenum in causing and maintenance of chronic gastritis, the author studied the effect of bromopride, a drug regulating gastrointestinal motility, on the subjective complaints of individuals suffering from the disease. In a randomized double-blind trial, 31 subjects with upper abdominal complaints, histologically established antrum gastritis and endoscopic signs for disorders of pyloric function were treated with one capsule three times daily of bromopride or a placebo, over a period of three weeks. The positive therapeutic results in 12 of 13 patients on bromopride provide support for the clinical use of a drug regulating gastrointestinal motility in the treatment of duodeno-gastric reflux causing the discomfort of individuals with chronic gastritis. Subjects exhibiting a sensation of fullness and pressure, flatulence, pain in the epigastrium and eructations, were found to be most responsive to bromopride. No relationship between side-effects and drug treatment was observed.

Abdomen↗

Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials.

BACKGROUND: Several lines of evidence suggest that supplementation of diet with omega-3 polyunsaturated fatty acids (omega-3 PUFA), commonly referred to as fish oils, may reduce blood pressure (BP). However, most clinical trials of omega-3 PUFA supplementation have been of insufficient size to detect relevant BP changes. METHODS: We conducted a meta-analysis of 17 controlled clinical trials of omega-3 PUFA supplementation. To estimate an overall effect of omega-3 PUFA supplementation on BP, we calculated the net BP change in each trial (BP delta in omega-3 PUFA group minus BP delta in control group), which was then weighted according to the inverse of the variance. RESULTS: In the 11 trials that enrolled normotensive individuals (n = 728), omega-3 PUFA supplementation led to significant reductions of systolic BP (SBP) and diastolic BP (DBP) in two and one trials, respectively. In the six studies that enrolled untreated hypertensives (n = 291), significant reductions of SBP and DBP were present in two and four trials, respectively. Weighted, pooled estimates of SBP and DBP change (mm Hg) with 95% confidence intervals were -1.0 (-2.0 to 0.0) and -0.5 (-1.2 to +0.2) in the trials of normotensives, and -5.5 (-8.1 to -2.9) and -3.5 (-5.0 to -2.1) in the trials of untreated hypertensives. In 13 of 17 studies, trial duration was less than 3 months. Doses of omega-3 PUFA tended to be high (average dose > 3 g/d in 11 trials). The magnitude of BP reduction was greatest at high BP but was not significantly associated with dose of omega-3 PUFA. Side effects, most commonly eructation and a fishy taste, occurred more frequently in omega-3 PUFA participants than in control participants (28% vs 13%, P < .001). CONCLUSIONS: Our analyses indicate that diet supplementation with a relatively high dose of omega-3 PUFA, generally more than 3 g/d, can lead to clinically relevant BP reductions in individuals with untreated hypertension. However, use of omega-3 PUFA as antihypertensive therapy will require demonstration of long-term efficacy and patient acceptability of lower doses.

Adult↗

[Stress and the digestive system].

Functional disorders mainly occur in young, anxious hyperactive, sometimes obsessional patients and involve all parts of digestive tract: feeling of obstruction the upper oesophagus or dysphagia; aerophagia related to a slow gastric emptying or gastric fullness relieved by eructation; biliary vomiting and pain in right abdominal upper quadrant which might correspond to a form of migraine without headache; irritable bowel, characterized by abdominal discomfort and constipation. Obviously, the diagnosis of functional disorders required elimination of an organic disease by appropriate endoscopic investigations. Psychosomatic disorders mainly comprise gastroduodenal ulcers and inflammatory bowel diseases. Although psychologic profiles have been associated with gastro-duodenal ulcer, these are not necessary for the development of the disease. The role of emotional factors has decreased since very efficient anti-secretory drugs are available. Inflammatory bowel diseases, in particular ulcerative colitis is frequently associated to behaviour disorders. The patient is usually a young woman brought up by an overprotective family. It is generally recognized that attacks of ulcerative colitis may be triggered by emotional factors. Thus, Stress may interact with digestive tract. In some cases, as in patients with irritable bowel or distal ulcerative colitis, psychotherapy such as Schultz's Autogenous Training, improves the patient's condition.

Arousal↗

[Helicobacter detected in children of Helicobacter pylori-positive parents].

The authors examined 48 children of Helicobacter pylori positive parents: 52% were serologically positive for Helicobacter pylori using the Orion Diagnostics Pyloriset Latex agglutination test. Of these children 10 had upper abdominal pain, heartburn and acid eructation and osesophagogastroscopy was performed; seven were found to be Helicobacter pylori positive histologically. These results draw attention to the transmission of Helicobacter pylori infection within families. They suggest that these children should be reviewed regularly, and the diagnostical examinations need to perform if the clinical picture is suspicious of Helicobacter pylori infection.

Adult↗

[Results of surgical treatment of complicated paraesophageal hernias].

From January 1979 to May 1995, 18 patients (4 men, 14 women) with a mean age of 75.4 +/- 12.5 yr underwent surgery for a complicated paraesophageal hiatus hernia. In 5 patients, the complication was the first sign of the diagnosis. Thirteen patients had a history of digestive, respiratory, or cardiac symptoms (mean duration of symptoms 74 mo.; range 2-240 mo.); 9 of them were aware that they had a hiatus hernia. Ten patients presented with acute obstruction (associated with a perforation in 1 case, jaundice in 1 case, and righy lower lobe pneumonia in 1 case). Hemorrhage occurred in 6 patients (hematemesis 4 cases, melena 2 cases). One patient had a perforation and another had an abscess of the lower right lobe. Surgery was performed via a transabdominal approach in all cases (5 times as an emergency, 12 times as a delayed emergency procedure, and once as an elective procedure). The procedure was delayed in 13 cases because of successful nasogastric decompression. All patients underwent reintegration of the stomach, diaphragmatic repair and gastropexy. An antireflux procedure was performed in 14 cases. Seven patients had an ancillary procedure (including one splenectomy following decapsulation). There were no postoperative deaths. Two patients who underwent emergency surgery developed a benign complication. The outcome of 17 patients is known; none of them developed a recurrence. One patient who did not undergo an antireflux procedure presented with gastroesophageal reflux; another experienced pain during eructation. In conclusion, nearly two-thirds of all patients who present with an acute complication can benefit from medical preparation before surgery, a strategy that improves results.

Aged↗

The prevalence and clinical characteristics of short segments of specialized intestinal metaplasia in the distal esophagus on routine endoscopy.

OBJECTIVE: To prospectively determine the prevalence and clinical characteristics of short segments of specialized intestinal metaplasia in the distal esophagus. Short segment is defined as extending less than 2 cm proximal to the esophagogastric junction. This has been referred to by some investigators as "short segment Barrett's esophagus." METHODS: One hundred and seventy two patients undergoing elective esophagogastroduodenoscopy were consecutively enrolled. Patients with known Barrett's esophagus were excluded. All study patients completed a symptom questionnaire. At endoscopy, the presence of esophagitis and locations of the diaphragmatic hiatus, esophagogastric junction, and the squamocolumnar junction were recorded. Biopsy specimens were obtained at the squamocolumnar junction to identify specialized intestinal metaplasia and 2 cm above the squamocolumnar junction to evaluate for histological esophagitis. RESULTS: Two patients (1.2%) had at least 2 cm of columnar-lined esophagus. Of the 170 patients without 2 cm of columnar-lined esophagus, 16 (9.4%) patients had short segments of specialized intestinal metaplasia. Twelve (7.0%) of these patients had specialized intestinal metaplasia limited to the esophagogastric junction. All patients with specialized intestinal metaplasia were Caucasian, and there was a slight male predominance. Patients without specialized intestinal metaplasia (n = 154, 90.6%) did not differ statistically with respect to age, gender, use of acid-suppressing drugs, alcohol, or smoking history. Pyrosis and regurgitation were significantly more common in patients with specialized intestinal metaplasia involving the distal 2 cm of the esophagus or the esophagogastric junction. Cough was more common in the group with specialized intestinal metaplasia limited to the esophagogastric junction. The groups were similar in frequency of dysphagia, globus sensation, nocturnal pyrosis, eructation, early satiety, nausea, and abdominal pain. CONCLUSIONS: Specialized intestinal metaplasia less than 2 cm proximal to the esophagogastric junction is common in Caucasian patients undergoing routine esophagogastroduodenoscopy. Pyrosis and regurgitation are significantly more common in patients with short segments of specialized intestinal metaplasia, whether involving the distal 2 cm of the esophagus or the esophagogastric junction alone. Alcohol and tobacco use are no more common in patients with specialized intestinal metaplasia than in those without metaplasia. The presence of specialized intestinal metaplasia did not correlate with either endoscopic or histological esophagitis.

Age Distribution↗

Gastroparesis: current management.

Gastroparesis is delayed gastric emptying of either solids or liquids, which occurs in the absence of mechanical obstruction. Although associated with many diseases, the most frequent cause of gastroparesis is diabetes mellitus. It is estimated that up to 50% of diabetic patients may have this problem. Symptoms of gastroparesis include postprandial nausea, epigastric pain/burning, bloating, early satiety, excessive eructation, anorexia and vomiting. The vomiting associated with gastroparesis often has the following two features: (1) emesis of undigested foods ingested more than four hours previous; and (2) emesis of undigested foods in the middle of the night or in the morning prior to eating breakfast. It is important to recognize and treat gastroparesis not only to decrease symptoms but also to prevent bezoar formation and nutritional deficiencies as well as to improve glycemic control in brittle diabetics. The purpose of this article is to review the physiology of gastric emptying and to use this information to understand the pharmacological therapies for this debilitating problem.

Gastroparesis↗

Phase I clinical trial of perillyl alcohol administered daily.

Perillyl alcohol (POH; NSC-641066), a naturally occurring monoterpene, has shown antitumor and preventive activity in preclinical studies in rodent models. Drug-related activities that have been observed include the induction of apoptosis, cell cycle arrest, the inhibition of posttranslational modification of proteins that are involved in signal transduction, and differential gene regulation. We treated 18 patients who had advanced malignancies with POH, which was given on a continuous three-times-a-day schedule at the following doses: (a) level 1 (L1), 800 mg/m2/dose; (b) level 2 (L2), 1600 mg/m2/dose; and (c) level 3 (L3), 2400 mg/m2/dose. The main toxicity, which seemed to be dose related, was gastrointestinal and included nausea and vomiting, anorexia, unpleasant taste, satiety, and eructation. Two heavily pretreated ovarian cancer patients experienced reversible > or =grade 3 granulocytopenia. Grade 1-2 fatigue was also noted. The parent drug was not detectable in the plasma. The mean peak plasma levels of the two main metabolites on days 1 and 29 were 175 and 139 microM (L1), 472 and 311 microM (L2), and 456 and 257 microM (L3) for perillic acid (PA) and 7.1 and 9.8 microM (L1), 34.2 and 34.0 microM (L2), and 26.2 and 23.4 microM (L3) for dihydroperillic acid (DHPA). Peak levels were noted 2-3 h postingestion for PA and 3-5 h postingestion for DHPA. Metabolite half-lives measured about 2 h for each. POH, PA, and DHPA were detectable in the urine of all patients at L3. About 9% of the total dose was recovered in the first 24 h. The majority was recovered as PA; less than 1% was recovered as POH. Disease stabilization for > or =6 months was seen, although no objective tumor responses were noted. Further study of POH continues with a more frequent dosing schedule.

Adult↗

Forestomach motility in llamas and camels.

Major aspects of forestomach anatomy in llamas and camels are described. The pattern of forestomach motility is a succession of motoric cycles, consisting of A- and B-contraction sequences and a pause. Respective differences between llamas and camels are discussed. Observations on regulation of motility are mentioned. Occurrences and courses of rumination and eructation within the motility cycles are emphasized. Motility of the forestomach achieves a selective retention of feed particles in the forestomach; a long retention time is a prerequisite for an effective microbial digestion, especially of poor quality feed.

Animals↗