bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemodynamic responses to 1.25 and 2 mg of terlipressin intravenously in man
Authors: FREEMAN I. G. , BARTON J. R. , RECORD C. O. 
Published: July 2010

SUMMARYThe systemic and hepatic haemodynamic effects following terlipressin (Glypressin) administration were studied. Bolus intravenous injections of 1.25 and 2 mg significantly decreased wedged hepatic vein pressure gradient by 29% and 31%, respectively. With each dose there was a small increase in mean arterial blood pressure but after 1.25 mg of terlipressin, estimated hepatic blood flow fell by only 11% (not significant) compared to 24% after 2 mg, while the cardiac index fell by 12% compared to 29%. The adverse haemodynamic effects of terlipressin were diminished by a decrease in dosage, without any alteration in the beneficial effect of the drug upon portal pressure. Whether the smaller dose will be effective in arresting variceal haemorrhage remains to be determined.
Review: the pharmacological control of variceal bleeding
Authors: FREEMAN J. G. , RECORD C. O. 
Published: July 2010

SUMMARYThe haemodynamic effects and clinical uses of drugs used in the management of patients with oesophageal variceal bleeding are reviewed. Vasoconstrictor agents (vasopressin, teripressin) alone or in combination with nitrates continue to be used for acute bleeding episodes, while somatostatin is an alternative. Alpha‐ and beta‐adrenergic blocking drugs and vasodilators which lead to a sustained decrease in portal pressure can be used for the prevention of bleeding episodes, but despite numerous studies the pharmacological treatment of variceal bleeding remains controversial.
Three computer models for the calculation of prevalence of peptic ulcer disease during long‐term treatment
Authors: UNDERWOOD D. D. , AMOS J. C. , VENABLES C. W. , BARDHAN K. D. , BERESFORD J. , HALIBURN C. , McCARTHY C. F. , WEIR D. G. 
Published: July 2010

SUMMARYAt present the effects of maintenance treatment for peptic ulcer disease are usually calculated by using ‘life‐table’ analyses. Whilst these accurately demonstrate the speed with which an initial relapse occurs they make no allowance for the fact that, in clinical practice, a relapse often responds to a further course of full‐dose treatment and the patient then returns to maintenance therapy. A further compounding factor is that, in any long‐term study, patients will be lost to follow‐up for a variety of reasons not all related to failure of the treatment.In this paper we describe the use of ‘prevalence rates’ to better reflect the outcome of peptic ulcer management. Three ‘computer models’, which have been developed to address the problems of patients leaving the study for any reason during such a long time‐period, are also described, as are the underlying assumptions made.Using the results from a long‐term study of continuous treatment with cimetidine,1 the ‘prevalence rates’ of ulcer disease over 6 years were calculated. Observed relapse rates appeared to fall with time (from 2.7% for duodenal ulcer (DU) and 2.5% for gastric ulcer (GU) to 1% and 2% respectively). However, on applying the models to the data, prevalence rates tended to rise slowly with time for the first 3 years in each of the models tested. At 6 years, two of the models suggested that the prevalence rate for DU would be about 8%; this is not very different to the reported recurrence rate after surgical treatment by truncal vagotomy and pyloroplasty.It is concluded that ‘prevalence rates’ should be used to assess long‐term medical treatments for ulcer disease. Similar methods could also be used to examine the medical treatment of any other disease where multiple relapses, capable of responding to re‐treatment, occur. The use of models proved beneficial in compensating for patients lost during the study.
Inhibitory effect of isoprenaline on gastric acid secretion in the rat. The role of endogenous histamine
Authors: HEYLINGS J. R. , REDFERN J. S. , FELDMAN M. 
Published: July 2010

SUMMARYIn dogs beta‐adrenoreceptor agonists inhibit gastric acid secretion stimulated by exogenous gastrin to a much greater extent than acid secretion stimulated by exogenous histamine. One possible explanation for this observation is that endogenous histamine is important in gastrin‐mediated acid secretion and that isoprenaline and related beta‐adrenoreceptor agonists block gastric mucosal histamine release. This possibility was tested in the present study in gastric lumen‐perfused anaesthetized rats. Intravenous infusion of isoprenaline (12 μg kg−1 h−1) inhibited maximal, pentagastrin‐stimulated acid output by 50–70% (P < 0.01), but had no significant inhibitory effect on the maximal acid secretory response to histamine. In contrast to its inhibitory effect on gastrin‐stimulated acid output, isoproterenol had no effect on gastric histamine output during pentagastrin infusion. We conclude that isoprenaline selectively inhibits gastrin‐stimulated acid secretion in the rat, as in the dog, and by a mechanism other than inhibiting gastric histamine release.
Effect of 10 mg and 20 mg omeprazole daily on duodenal ulcer: double‐blind comparative trial
Authors: LAURITSEN K. , ANDERSEN B. N. , HAVELUND T. , LAURSEN L. S. , HANSEN J. , ERIKSEN J. , JØRGENSEN T. , RASK‐MADSEN J. 
Published: July 2010

SUMMARYOne‐hundred and seventy‐one patients with endoscopically proven duodenal ulcers were allocated at random to double‐blind treatment with 10 or 20 mg of omeprazole in the morning for up to 4 weeks. Patients completed the study if ulcer healing and pain relief had occurred at 2 weeks. A total of 155 patients completed the trial. Patients treated with 20 mg of omeprazole daily responded significantly more rapidly than those treated with 10 mg of omeprazole daily (P < 0.001; Cochran‐Mantel‐Haenszel test covering both time points), cumulative healing rates at 2 and 4 weeks were 74% (58/78) and 91% (71/78), respectively. The corresponding rates in the group treated with 10 mg daily were 48% (39/81) and 75% (58/77). Pain relief was again more pronounced during treatment with the larger dose (P < 0.05; stratified Wilcoxon test). No major clinical or biochemical side effects were noted. An omeprazole dose of 20 mg daily is preferable to a lower dose for the treatment of duodenal ulcer disease in the short term.
Antroduodenal motility and gastric emptying. Gastroduodenal motility and pH following ingestion of paracetamol
Authors: SCHURIZEK B. A. , KRAGLUND K. , ANDREASEN F. , VINTER‐JENSEN L. , JUHL B. 
Published: July 2010

SUMMARYThe influence of paracetamol on antroduodenal motility and gastric pH was studied in 11 healthy subjects and the relationship between gastroduodenal motility and gastric emptying rate time, tmax, to peak concentration of serum paracetamol, Cmax, was evaluated. The incidence of antral phase III activity and the duration of phase III was diminished with paracetamol (P < 0.05). The other motility parameters assessed were unchanged.Three patterns of motility and absorption were observed. One group (n= 5) were fast absorbers with a tmax of 1 h and a motility pattern characterized by antral activity, a high motility index and a short duration of phase II (33–60 min); the phase IIIs were complete except in one case. The second group (n= 4) had tmax at 1.5 h and their phase II motility was characterized by a longer duration (80–133 min) (P < 0.05), by antral activity, and by a high motility index; their phase IIIs were all incomplete. The last group (n= 2) were slow absorbers: Cmax was not reached in the investigation period, no antral contractions were seen, and the motility index was low. The area under the serum‐concentration curve of paracetamol differed between the groups at 90 and 180 min (P > 0.01).
Review article: a role for gastrointestinal prokinetic agents in the treatment of reflux oesophagitis?
Authors: VERLINDEN M. 
Published: July 2010

SUMMARYGastro‐oesophageal reflux disease may result from a host of factors. Medical therapy has largely been aimed at neutralizing acid or decreasing acid production but improvement of upper‐gastrointestinal motility may prove to be a valuable treatment modality as well. This paper reviews the current state of knowledge of the pathogenesis of reflux disease and concentrates upon promotility treatment with domperidone, metoclopramide and cisapride.
Low‐dose cyclosporin for Crohn's disease: implications for clinical trials
Authors: BRYNSKOV J. , BINDER V. , RIIS P. , LAURITSEN K. , DE MUCKADELL O. SCHAFFALITZKY , FREUND L. , FALLINGBORG J. , RASMUSSEN S. NØRBY , MATZEN P. , KRAG E. , TAGE‐JENSEN U. , JARNUMS S. 
Published: July 2010

SUMMARYCyclosporin is a potent immunosuppressant, which has gained recent interest as a possible treatment for Crohn's disease. Chronic nephrotoxicity, however, has recently been demonstrated as a result of early treatment with high initial cyclosporin doses. We report the effect of a 3‐month treatment with low‐dose cyclosporin (5–7.5 mg kg−1 day−1) in 11 chronically active, therapy‐resistant Crohn's disease patients. Eight of the 11 patients (72%) improved according to a clinical grading score and the Dutch Activity Index whereas 9/11 (82%) improved according to the Crohn's Disease Activity Index (P < 0.05) after 1 month. Three patients were withdrawn despite clinical improvement. One developed arterial hypertension, one dropped out and one required surgical treatment due to a small bowel stricture. Five patients (45%) completed the treatment period with improved clinical scores. After tapering‐off, two patients (18%) were better at follow‐up. No serious side‐effects were encountered and it is concluded that low‐dose cyclosporin treatment should be further investigated in Crohn's disease.
The effects of octreotide, soy polysaccharide, codeine and loperamide on nutrient, fluid and electrolyte absorption in the short‐bowel syndrome
Authors: RODRIGUES C. A. , LENNARD‐JONES J. E. , THOMPSON D. G. , FARTHING M. J. G. 
Published: July 2010

SUMMARYFour agents, which could delay intestinal transit, were tested in six short‐bowel patients (jejunal length 30–120 cm) on long‐term nutritional/ electrolyte replacement therapy. Intestinal transit time of a liquid test meal and nutrient, water and sodium absorption were measured during a control study and with each test agent on separate days. Soy polysaccharide tended to increase transit time, but decreased the absorption of water, sodium and nutrients. Codeine phosphate and loperamide caused inconsistent and clinically unimportant changes. Octreotide, a long‐acting analogue of somatostatin, delayed transit and increased water, sodium and calorie absorption from the meal. Octreotide appears to have the potential to reduce the need for electrolyte and nutritional supplements in patients with the short‐bowel syndrome.
Effects of cimetropium bromide on gastrointestinal transit time in patients with irritable bowel syndrome
Authors: PASSARETTI S. , GUSLANDI M. , IMBIMBO B. P. , DANIOTTI S. , TITTOBELLO A. 
Published: July 2010

SUMMARYCimetropium bromide is a new antimuscarinic compound with strong antispasmodic activity. The aim of this study was to evaluate the effects of oral cimetropium bromide on total gut transit time in patients with irritable bowel syndrome. Forty patients, divided according to their initial total gastrointestinal transit times and presenting symptoms, were treated with cimetropium bromide 50 mg t.d.s. or placebo for 1 month according to a double‐blind, parallel group design. Before and after treatment all subjects ingested 24 radio‐opaque markers. The total intestinal transit time was determined by evaluating the rate of disappearance of markers from plain X‐ray films of the abdomen taken every 24 h for 4 days. Pain and bowel habits were also monitored. Seven patients did not complete the study. Cimetropium bromide significantly (P < 0.01) shortened the whole gut transit time in patients with prolonged transit time (80.8 ± 4.0 h before vs 60.8 ± 6.7 h after treatment) and improved the global clinical condition significantly compared with placebo (P= 0.029). In patients with a short total intestinal transit time, cimetropium bromide had no effect on whole gut transit time and did not significantly improve symptoms. The results of this study indicate that oral cimetropium bromide is effective both objectively and subjectively in a subgroup of irritable bowel syndrome patients with constipation.
Inappropriate use of metronidazole in gastrointestinal surgery
Authors: INGOLDBY C. J. H. , DEAN P. H. , VOWDEN P. , GILES G. R. 
Published: July 2010

SUMMARYPharmacokinetic data suggest that current treatment regimens of metronidazole in abdominal surgery are not always appropriate. We have examined antibiotic concentrations during emergency and elective surgery using a specific and sensitive high pressure liquid chromatography assay. Serum and tissue concentrations were measured after intravenous infusion during intra‐abdominal surgery and after suppositories given before appendicectomy. After intravenous dosage, bactericidal concentrations were reached in serum (13.6 ± 7.8 μ/ml), bowel (9.0 ± 6.6 μ/g), tumour (9.9 ± 7.1 μ/g) and subcutaneous fat (4.9 ± 3.2 μ/g). After suppositories the concentrations were: serum 4.6 ± 2.7 μ/ml, appendix 1.1 ± 0.6 μ/g, fat 1.5 ± 0.9 μ/g and peritoneal fluid 4.7 ± 4.3 μ/g. These values were obtained at a mean interval of 86.9 ± 27.5 min following administration of the drug.Serum concentrations were measured during post‐surgical infusion of 500 mg i.v. 8 or 12 hourly. Mean concentrations after 8 hourly doses were 16.3 ± 4.85 μ/ml pre‐dose and 28.7 ± 6.76 μ/ml post‐dose, with evidence of drug accumulation by detection of metabolites. Twelve hourly infusions gave pre‐dose levels of 7.4 ± 3.86 μ/ml and post‐dose levels of 17.1 ± 3.69 μ/ml.Metronidazole (500 mg) intravenously at induction of anaesthetic gives effective prophylactic concentrations in all tissues including tumour, but a metronidazole 1g suppository before appendicectomy does not provide reliable tissue concentrations. Metronidazole (500 mg) i.v. 12 hourly gives effective bactericidal concentrations of the drug and is more economical.
Natural history of Campylobacter pylori in duodenal ulceration treated with an H2‐antagonist
Authors: HO J. , HUI W.‐M. , NG I. , LAM S.‐K. 
Published: July 2010

SUMMARYCampylobacter pylori has been associated closely with active antral gastritis and duodenal ulcer but its pathogenetic role remains uncertain. The present longitudinal study examined, prospectively, the endoscopic antral biopsies of 45 patients with duodenal ulceration, taken before and after healing of the duodenal ulcer, during remission and at relapse. The biopsies were examined for the activity and degree of chronic inflammation of the gastritis and for the occurrence and density of C. pylori by Warthin‐Starry stain. Before treatment the frequency of chronic active antral gastritis was 100% and the occurrence of C. pylori was 97%. Compared with the pre‐treatment state, there was no significant change in either the frequency and severity of antral gastritis, or in the occurrence and density of the bacteria in the antral mucosa at the time the duodenal ulcer healed, during remission, or at relapse. The occurrence of the bacteria was significantly more frequent during remission, than at the time when the ulcer had healed initially (P < 0.05). These results suggest that the bacterium may not play an important pathogenetic role in ulcer healing and relapse, when patients are managed using an H2‐blocker.
Therapeutic potential of fish oil in the treatment of ulcerative colitis
Authors: McCALL T. B. , O'LEARY D. , BLOOMFIELD J. , Ó'MORÁIN C. A. 
Published: July 2010

SUMMARYIn a pilot study six patients with active ulcerative colitis and six healthy controls were given fish oil (MaxEPA) containing 3–4 g of eicosapentaenoic acid daily for a period of 12 weeks. There was a significant improvement in the patients' symptoms and histological appearance of the rectal mucosa by the end of the treatment period. There was a significant fall in neutrophil chemiluminescence during treatment in patients, whereas no change was observed in the control group. Neutrophil leukotriene B4 levels fell significantly during treatment. Serum from patients receiving fish oil was significantly less chemotactic for neutrophils compared with control serum. Eicosapentaenoic acid inhibited neutrophil chemotaxis and chemiluminescence in vitro. The omega‐3 fatty acids, which occur naturally in fish oils, may exert a beneficial effect by decreasing the production of inflammatory mediators.
Comparison of 40 mg famotidine nightly and 150 mg ranitidine b.d.: ulcer healing and symptom relief in benign gastric ulcer
Authors: COCHRAN K. M. , COCKEL R. , CROWE J. , DICKINSON R. J. , GENT A. E. , KENNEDY N. P. , ROYSTON C. M. S. , CEDAR E. , MANN S. G. 
Published: July 2010

SUMMARYTwo hundred and eight patients with benign gastric ulcers seen on endoscopy were recruited by 13 hospitals in the United Kingdom and Ireland into this double‐blind study. Patients were assigned by prerandomized schedule to 8 weeks of treatment with either 40 mg famotidine at night or 150 mg ranitidine b.d. Repeat endoscopy confirmed complete ulcer healing in 62 of 77 evaluable patients in the famotidine group (81%) and 58 of 71 in the ranitidine group (82%). The treatments were equally effective in promptly relieving day and night pain. Adverse events were uncommon; dizziness and headaches were the most frequently reported in both groups. In conclusion, night‐time famotidine is as effective as twice daily ranitidine in healing benign gastric ulcers and provides similarly rapid symptomatic relief.
Ranitidine maintenance treatment of non‐steroidal anti‐inflammatory drug‐induced duodenal ulceration
Authors: PENSTON J. G. , WORMSLEY K. G. 
Published: July 2010

SUMMARYFifty‐six patients who presented with non‐steroidal anti‐inflammatory drug‐associated duodenal ulcers received maintenance treatment with ranitidine. Forty‐eight of these patients stopped treatment with nonsteroidal anti‐inflammatory drugs. The cumulative symptomatic remission at the end of 5 years of maintenance treatment was 97.7%. While half the patients had presented with haemorrhage from the ulcer, only one patient bled during maintenance treatment, giving a cumulative risk of 2.3% in 5 years of maintenance treatment.We conclude that maintenance treatment with ranitidine effectively and safely keeps patients with non‐steroidal anti‐inflammatory drugassociated ulcers symptom‐ and risk‐free.
Single night‐time doses of 40 mg famotidine or 800 mg cimetidine in the treatment of duodenal ulcer
Authors: LEE F. I. , BOOTH S. N. , COCHRAN K. M. , CROWE J. , DICKINSONS R. J. , KENNEDY N. P. , COTTRELL J. , MANN S. G. 
Published: July 2010

SUMMARYFamotidine (40 mg) and 800 mg cimetidine as single night‐time doses were compared in a randomized, double‐blind, multicentre study of acute treatment for duodenal ulceration. Fifteen centres recruited 304 patients into the study. Of these, 274 were included for analysis, with 136 receiving famotidine and 138 receiving cimetidine. After 4 weeks, 75% of the patients who received famotidine and 77% of the patients who received cimetidine were healed. At 6 weeks the cumulative healing rates were 91% with famotidine and 87% with cimetidine. Differences between the groups were not significant at 4 or 6 weeks. No significant difference in healing rates between smokers and non‐smokers was found. Day and night pain resolved rapidly in both groups. Both treatments were well‐tolerated; adverse events were reported in 17 patients on famotidine and 18 on cimetidine, with headache the most frequent event in both groups. Famotidine is effective and well‐tolerated in the shortterm treatment of duodenal ulcer.
Acute damage of gastroduodenal mucosa by acetylsalicylic acid: no prolonged protection by antacids
Authors: BERSTAD K. , HARAM E.‐M. , WEBERG R. , BERSTAD A. 
Published: July 2010

SUMMARYTwenty healthy volunteers participated in a double‐blind, crossover study to evaluate endoscopically whether low‐dose antacids have any prolonged and pH‐independent protective capacity against gastroduodenal mucosal damage induced by acetylsalicylic acid. Antacid or placebo one tablet q.d.s. was given for 1.5 days. Acetylsalicylic acid (1.5 g) was administered 3 h after the last dose of antacid/placebo, and gastroscopy was performed 1 h thereafter. Thirteen of 20 subjects showed a decrease in total damage with antacids as compared with placebo, but the difference did not reach statistical significance. Thus, protection by antacids against acetylsalacylic acid‐induced gastric mucosal lesions could not be documented at a time when intragastric pH presumably had returned to normal.
Galanin: hydrokinetic action on salivary glands in man
Authors: BAUER F. E. , GHATEI M. A. , ZINTEL A. , BLOOM S. R. 
Published: July 2010

SUMMARYGalanin was infused intravenously into eight healthy volunteers at a dose of 40 pmol kg−1 min−1 for 1 h to investigate the pharmacological effects of this peptide on the postprandial sialagogical response in man. Galanin significantly increased the salivary volume and the saliva output of sodium, chloride and bicarbonate compared to control saline infusion, but had no effect on the output of potassium and α‐amylase. An increase in salivary pH was also observed. The increase in salivary volume may indicate a physiological role of galanin in the control of salivary secretion.
pH‐Profile and regional transit times of the normal gut measured by a radiotelemetry device
Authors: FALLINGBORG J. , CHRISTENSEN L. A. , INGEMAN‐NIELSEN M. , JACOBSEN B. A. , ABILDGAARD K. , RASMUSSEN H. H. 
Published: July 2010

SUMMARYThe pH of the gut lumen was measured in 39 healthy persons using a pH‐sensitive, radiotransmitting capsule. Thirteen persons were studied twice. The location of the capsule was determined by X‐ray. The pH rose from 6.4 in the duodenum to 7.3 in the distal part of the small intestine. In 17 persons the pH dropped by 0.1–0.8 pH units during the last hours of the small intestinal transit. The pH was 5.7 in the caecum, but rose to 6.6 in the rectum. Gastric residence time was 1.1 h, small intestinal transit was 8 h, and colonic transit time was 17.5 h (median values). The results provide a firmer basis for prediction of the level, and the rate of release of active substance from pH‐dependent sustained‐release oral preparations.
The effect of enprostil on duodeno‐jejunal motility in man
Authors: DUCROTTE P. , PARENT B. , MASLIAH C. , JOUBERT M. , COLIN R. , DENIS P. 
Published: July 2010

SUMMARYMotor changes could be involved in the pathogenesis of diarrhoea that complicates the treatment of ulcer disease by prostaglandins. Our aim was to assess the effect of enprostil, a synthetic analogue of PGE2, on duodeno‐jejunal motility. During this randomized double‐blind crossover study, two manometric recordings, each lasting 20 h (12.00‐08.00 hours), were carried out during dosing with 35 μg enprostil b.d. or placebo (eight volunteers: part 1), or during dosing with 35 or 70 μg enprostil b.d. (nine volunteers: part 2). Subjects were only allowed a standard dinner at 18.00 hours.During fasting, in part 1, the number of phase 3 activity patterns (PIIIs) was higher with enprostil than with placebo (P < 0.01), without any difference in their characteristics; the overall duration of phase 1 activity was longer with enprostil than with placebo (P < 0.01). In part 2, during fasting the number and characteristics of the PIIIs were not different, but there was a dose‐related increase in PI, and decrease in PII activity. Fed motor patterns did not differ between the two doses of enprostil.