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At least 235 records · Page 13Linked to original sources
PubMed1989

The role of ceroid in lung and gastrointestinal disease in Hermansky-Pudlak syndrome.

Studies of ceroid associated lesions in Hermansky-Pudlak syndrome (HPS) indicate that restrictive lung disease and granulomatous gastrointestinal lesions are among the most frequent and account for 60% of the deaths of the patients. No defects in the immune system in HPS were found. Histological, ultrastructural and chemical studies show accumulation of non-biodegradable ceroid in tissue cells and associated macrophages of HPS patients. There is no known degradative pathway for ceroid. Ceroid is eliminated from cells by exocytosis. Wild type and pale eared mice treated with leupeptin, which inhibits exocytosis, accumulate ceroid in organ cells in the same sequence seen in HPS. Young HPS patients without significant pulmonary function deficits were lavaged, the macrophages examined by TEM and tested for platelet derived growth factor. Macrophages contained ceroid and 7/12 patients had 27 +/- 42 units of PDGF bioactivity compared to zero activity in controls. Purified ceroid was fed to macrophages lavaged from the lungs of non-smoking control subjects. Prior to feeding, less than 5% of cells contained one or two small yellow-orange autofluorescent granules resembling ceroid. After feeding, approximately 20% of control cells had ingested ceroid, but PDGF was not increased. The immunologic and histologic studies and the production of PDGF by macrophages which precedes lung fibrosis all point to a central role of the macrophage in these lesions. These studies did not distinguish whether the macrophages ingested ceroid from other cells, or whether ceroid is produced intrinsically by the HPS macrophage.

Adolescent↗
PubMedDate not supplied

Leukocyte-endothelial cell interactions: implications for the pathogenesis and treatment of gastrointestinal disease.

Evidence implicating leukocytes as mediators of tissue injury in different disease processes is accumulating rapidly. The sequestration and activation of neutrophils have been shown to be key components in the pathophysiology of chronic inflammatory bowel diseases, and in gastrointestinal lesions following hemorrhagic shock, ischemia-reperfusion, and ingestion of nonsteroidal anti-inflammatory drugs, or ethanol. Leukocyte-endothelial cell interactions also appear to be a target for the action of various drugs proven to be useful in the treatment of gastrointestinal inflammatory disorders. This review focuses on the alterations in leukocyte-endothelial cell interactions in the aforementioned conditions.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1979

A study of occupational status, responsibility and authority in patients with duodenal ulcers, other gastrointestinal diseases and controls.

Five hundred and twenty-two African and Indian patients were studied, including 206 with duodenal ulcers, 25 with irritable colon, 51 with oesophagitis, 31 with pancreatitis, 14 with ulcerative colitis or Crohn's disease, 71 miscellaneous gastrointestinal diagnoses and 124 controls. The mean ages were similar in each group. Every patient underwent endoscopy and a detailed psychosocial questionnaire was applied. Comparison of occupations of patients and their patients was investigated on 3 scales, for Status/Prestige (9 levels), Responsibility (5 levels) and Control over Others (10 levels). Significantly more patients with duodenal ulcers were in the lowest group in terms of occupational authority compared to other diagnoses and controls. Similar number of all groups had been urban for their entire life. Stress was present in the 10 days preceding an attack in significantly more Indian males with duodenal ulcers compared to controls. Upward shifts in prestige had not occurred in African male patients with duodenal ulcers when compared to their parents but had occurred among Indian men. More duodenal ulcer patients were in the very lowest occupational authority category compared to other groups. It may thus not be occupational prestige as such that is important, but factors associated with it, such as lack of control over others and, among Indian men, stresses associated with social disruption following upon occupation mobility.

Africa↗
PubMed1985

Exudative pleural effusions secondary to gastrointestinal diseases.

Several different diseases of the gastrointestinal tract may have an associated exudative pleural effusion. In the acutely ill patient with a pleural effusion, the possibility of esophageal perforation should always be considered. It is important to establish this diagnosis as soon as possible since the mortality rate increases markedly if drainage of the mediastinum is delayed for even 12 or 24 hours. The best screening test for esophageal rupture is the level of amylase in the pleural fluid. All patients with undiagnosed exudative pleural effusions should have the amylase level in their pleural fluid measured to rule out a pancreatic etiology for their pleural effusion. In patients with acute pancreatitis, the clinical presentation may be dominated by chest symptoms. Such patients have small to moderately sized pleural effusions that resolve rapidly once appropriate therapy is instituted. If symptoms persist, the possibility of a pancreatic abscess or a pancreatic pseudocyst should be considered. Patients with pancreatic pseudocysts may develop a sinus tract between the pseudocyst and the pleural space. In this situation a large pleural effusion develops. Frequently there are no abdominal symptoms and the diagnosis will not be made unless a pleural fluid amylase is obtained. Patients with exudative pleural effusions that contain predominantly polymorphonuclear leukocytes should be suspected of having an intra-abdominal abscess, particularly when there is no associated parenchymal infiltrate. Subphrenic, intrahepatic, and splenic abscesses all have a high incidence of accompanying pleural effusion. Abdominal CT scanning is the method of choice to establish each of these diagnoses.

Abdomen↗
PubMed1994

Factors influencing the absorption of trace elements in healthy conditions and in gastrointestinal diseases.

Trace element metabolism is regulated by numerous factors among which absorption plays a key role. Nutritional imbalances or diseases affecting the gastrointestinal tract are therefore often implicated in the development of deficiency states. An overview of dietary factors linked to trace element metabolism and intestinal factors influencing absorption is given with special reference to zinc, copper and selenium.

Copper↗
PubMed2003

Management of osteoporosis in patients with gastrointestinal diseases.

Osteoporosis is a frequent complication in the course of various gastrointestinal disorders. Since its pathogenesis is complex, and incompletely understood in comparison to the well-known pathomechanism of postmenopausal osteoporosis, adequate management is difficult. We first summarize those therapeutic options which have strong evidence in postmenopausal osteoporosis and, thereafter, we review those in the context of different gastrointestinal diseases. Treatment of the underlying intestinal disorder seems to be most important to normalise altered bone metabolism and to prevent osteoporosis in patients with coeliac disease. In patients with osteoporosis associated with Crohn's disease, various treatment strategies (such as vitamin D, sodium fluoride, bisphosphonates) are discussed. In contrast to postmenopausal osteoporosis, interventional studies in secondary osteoporosis are often limited by the small study population and data about the efficacy of any treatment in prevention of fractures are therefore lacking. Well-conducted, controlled studies with the endpoint of preventing fractures are therefore required to optimise the treatment of osteoporosis in these patients.

Bone and Bones↗
PubMed1985

Endoscopy in gastrointestinal disease. Procedures that offer an alternative to surgery.

Today, endoscopic procedures are available to treat many diseases of the gastrointestinal tract that just a few years ago would have required surgery. These procedures have proved to be safe and effective and are well accepted by patients. When considering such a procedure, the primary care physician needs to be aware of its advantages and limitations and the nearest center where it can be obtained. Many new endoscopic surgical procedures are undergoing evaluation, and undoubtedly some will soon be incorporated into the armamentarium of the gastroenterologist. Until more data on their efficacy and safety are available, however, these procedures should remain within the realm of the clinical investigator.

Bile Duct Diseases↗
PubMed1983

Determination of circulating DNA levels in patients with benign or malignant gastrointestinal disease.

Previous studies showed that patients with neoplasms of various types and origins have abnormally high concentration of DNA in their serum. The current work compares circulating DNA levels in patients with benign or malignant disease of the gastrointestinal tract and determines the diagnostic value of such measurements. DNA was quantitated by radioimmunoassay capable of detecting 25 ng/ml, and as a simple and noninvasive test, it could be a useful addition to other diagnostic procedures. The GI tract was chosen because it affords a comparison of benign, precancerous, and malignant lesions of the same organ. Of the 386 patients studied prospectively, 48% had benign disease and mean DNA levels (+/- SE) of 118 +/- 14 ng/ml, whereas 52% had malignant disease and 412 +/- 63 ng DNA/ml. The difference was statistically significant (P less than 0.001). The DNA assay showed the highest sensitivity for pancreas carcinoma: 90% of the patients had DNA levels above 100 ng/ml, chosen as the upper normal limit. Simultaneous measurements of both DNA and carcinoembryonic antigen (CEA) resulted in increased sensitivity and specificity, even when either marker alone had low sensitivity (gastric carcinoma). The results indicate that serum DNA concentration is markedly elevated in malignancy, and moderately elevated in benign disease, as compared with normal controls. These findings may have diagnostic and prognostic value.

Carcinoembryonic Antigen↗
PubMed1998

Customising an international disease management model to the needs of individual countries. Application to upper gastrointestinal disease.

The baseline economic model for upper gastrointestinal (UGI) disease was developed in the context of patterns of care and resource use within the UK. It provided the opportunity to evaluate the extent to which an economic model developed in one country could be applied to meet the pharmacoeconomic information needs of decision makers in another. The choice of countries for analysis was restricted to countries within the International Gastro Primary Care Group (IGPCG) who had previously agreed on the appropriateness of the basic clinical algorithm to their domestic healthcare environment. This provided a potential sample of 9 countries (Australia, Austria, Germany, Italy, The Netherlands, Sweden, Switzerland, the UK and the USA) of which the UK, Germany, Sweden and Switzerland were chosen as providing a broad spectrum of strategic and operating environments in which to test the international transferability of the economic model. The process and results obtained provide valuable evidence of the extent to which economic analyses can be transferred across national borders.

Disease Management↗
PubMed1998

How do practicing clinicians manage Helicobacter pylori-related gastrointestinal diseases in Germany? A survey of gastroenterologists and family practitioners.

BACKGROUND: Since the bacterium H. pylori was identified in 1982, overwhelming evidence has implicated it as the causal factor in the occurrence and relapse of peptic ulcer disease. The major objective of this study was to examine the extent to which physicians recognize H. pylori as a causal agent in peptic ulcer disease or as potential cofactor in other gastrointestinal diseases, and the extent to which this knowledge has influenced diagnostic and therapeutic practices. MATERIALS AND METHODS: Using a national mail survey in Germany in September 1995, 1197 family practitioners and 1197 gastroenterologists were selected for the study. RESULTS: Of the surveyed physicians, 756 (32%) responded. Family practitioners treated almost 50% of their patients with initial presentation of suspected ulcer disease without ordering further diagnostic tests. More than 25% of the family practitioners and 14% of the gastroenterologists reported that they do not treat diagnosed H. pylori infection in the first presentation of duodenal ulcer. At the time we conducted the study, 22% of responding family practitioners and 5% of responding gastroenterologists treated the first presentation of H. pylori-positive ulcer disease with regimens determined to be ineffective according to the available literature. CONCLUSIONS: Gastroenterologists preferred to treat H. pylori infection when the associated disease was one for which a causal relationship had been more clearly established, while family practitioners showed less discrimination. In order to provide optimal therapy aimed at minimizing the course and consequences of H. pylori-related diseases, researchers in the field must ensure continuous dissemination of current knowledge.

Clinical Competence↗
PubMed1993

[Secondary osteopenia in gastrointestinal diseases].

Of 2557 patients with osteopenia examined during the past 17 years 1707 were classified as secondary osteoporosis and 406 as osteomalacia. Diseases of the gastrointestinal tract participate as the cause of osteoporosis in 635 patients (37.19%) and osteomalacia was the cause in 210 patients (51.72%). The highest ratio in osteoporoses are lactose intolerance--256 cases (14.99%); maldigestion was recorded in 305 patients (17.86%). This category comprises gastrectomies of both types, severe affections of the gallbladder and biliary pathways, insufficiency of the external pancreatic secretion, patients with frequent exacerbations of ulcerative colitis. Resections of the small intestine are on the borderline between maldigestion and malabsorption. Malabsorption alone was found in 74 patients (4.33%) and there is also sprue, M. Crohn, diverticulosis of the small intestine, diabetic enteropathy and scleroderma. In secondary osteomalacia the leading cause is hepatic damage recorded in 167 patients (41.13%) and malabsorption in 43 patients (10.59%).

Bone Diseases, Metabolic↗
PubMed1997

Relationship of Helicobacter pylori infection to several malignant and non-malignant gastrointestinal diseases.

The importance of the Helicobacter pylori infection was investigated as a risk factor for several gastrointestinal diseases. In this study 203 patients with gastric cancer, 61 with peptic ulcus, 60 with gastritis and 100 asymptomatic control subjects were investigated. Serum samples were examined for IgC antibodies to H. pylori by enzyme linked immunoassay - tissue samples were stained for H. pylori by Wartin-Stary technique and by Giemsa for routine histopathology. H. pylori seropositivity was 58.1% in gastric cancer, 54% in peptic ulcus, 63.3% in gastritis and 27% in asymptomatic control group. There was a 10.1% discordance between the serum and tumor determinants in the seropositive group and 11.3% of discordance in the seronegative group. The frequency of H. pylori seropositivity was lowest in cardia tumors (22.7%) and highest in antral tumors (65.5%, p=0.00002). H. pylori seropositivity was 29% in diffuse type of histology, 35% in mixed type and 79% in the intestinal type (p=0.00000). In the gastric cancer patients the frequent use of salty food (p=0.00001, OR=6.4), excessive salt, pickled food (p=0.0000, OR=24.92) and proteins (p=0.003, OR=0.45) were more significant than asymptomatic volunteers. In gastric cancer patients the frequent use of salty and pickled food were relevantly associated with H. pylori infection (p=0.001). It was concluded that H. pylori infection could play a role in the pathogenesis of non-malignant gastrointestinal diseases which may be the precursor of carcinoma. However, other contributing factors to carcinogenesis must be investigated.

Adenocarcinoma↗
PubMed1995

Dyspepsia in rural residents of Estonia. Life-style factors, psychoemotional disorders, and familial history of gastrointestinal diseases.

BACKGROUND: The association between dyspepsia and life-style factors, psychoemotional disorders, and familial history of gastrointestinal diseases was evaluated in a case-control study of dyspepsia. METHODS: A group of 500 consecutive dyspeptic patients, attending a rural health care center, and a sex- and age-matched control group (n = 500) were interviewed using a specially compiled questionnaire. RESULTS: The dyspeptic subjects showed a significantly higher prevalence of psychoemotional disorders (p < 0.001), irregular dietary regimen (p < 0.05), and familial history of gastrointestinal diseases. The number of ex-smokers was also larger in dyspeptic subjects (p < 0.05). CONCLUSIONS: Our study showed that the subject group with the heterogeneous syndrome of dyspepsia has several characteristics in common.

Adult↗
PubMed1998

Selenium depletion in patients with gastrointestinal diseases: are there any predictive factors?

BACKGROUND: Patients with intestinal disease are at risk of developing selenium deficiency due to impaired intestinal absorption. The aim of the present study was to evaluate selenium status and to identify predictive factors of selenium depletion in patients with gastrointestinal disease. METHODS: The concentration of selenium and the activity of glutathione peroxidase in plasma and erythrocytes were measured by fluorometry and by spectrophotometry. Eighty-six patients with Crohn's disease, 40 patients with ulcerative colitis, and 39 patients with various other gastrointestinal diseases were studied. Twenty-seven patients (16%) received home parenteral nutrition. Stool mass, faecal fat, and vitamin B12 absorption were analysed in 100 patients. RESULTS: The plasma selenium concentration was decreased in 85% of the patients receiving supplementary parenteral nutrition and in 20% of the patients receiving oral nutrition, among them in 26% of the patients with Crohn's disease. Almost all patients with ulcerative colitis had normal selenium levels. A statistically significant correlation was found between plasma selenium and vitamin B12 absorption, stool mass, faecal fat excretion, body mass index, P-albumin, P-zinc, and the length of the remaining small bowel. Stepwise regression analyses showed that the strongest predictors of selenium deficiency were stool mass, vitamin B12 absorption, and the length of the small-bowel resection. CONCLUSION: Selenium deficiency is common in patients with severe gastrointestinal disorders. The deficiency is mainly related to malabsorption, and a low selenium level was almost invariably present in patients who needed parenteral supplementation due to gut failure.

Adult↗