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  • 1
    Electronic Resource
    Electronic Resource
    Budesonide versus prednisolone retention enemas in active distal ulcerative colitis (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 8 (1994), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Methods: Efficacy and safety of the topically acting glucocorticosteroid budesonide retention enema (2.3 mg/ 11 5 mL) were compared with prednisolone disodium phosphate enema (31.25 mg/125 mL) in patients with active distal ulcerative colitis. The study was a randomized, multicentre trial, with two parallel groups and single-blind to the investigator. One hundred patients with active ulcerative colitis, not reaching beyond the splenic flexure as determined by endoscopy, were treated for up to 8 weeks. Results: Forty-five patients were randomized to receive budesonide and 5 5 to prednisolone. Both treatment groups improved significantly in terms of endoscopic and histological scoring during the study, but there were no statistically significant differences between the two groups. Clinical remission, defined as no more than three daily bowel movements without blood and endoscopically non-inflamed mucosa, was achieved in 16% of the patients in the budesonide group after four weeks and in 24% in the prednisolone group (N.S.).After 8 weeks treatment the clinical remission rate in the groups had increased to 36 % for budesonide and 47% for prednisolone (N.S.).Mean morning plasma cortisol levels were unchanged in the budesonide group, whereas they were significantly suppressed in the prednisolone group after 2, 4 and 8 weeks (P 〈 0.0001). Side effects were mild and rare in both groups. Conclusions: Treatment with budesonide enema in active distal ulcerative colitis was comparable, regarding efficacy, to treatment with conventional prednisolone enema. A prolongation of the treatment time from 4 to 8 weeks doubled the clinical remission rate in both groups. However, budesonide may be preferable to prednisolone since it causes less systemic effects as reflected by a lack of plasma cortisol suppression.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1994.tb00340.x
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  • 2
    Electronic Resource
    Electronic Resource
    Natural history of gastro-oesophageal reflux disease diagnosed in general practice (2004)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 20 (2004), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Cross-sectional studies indicate that gastro-oesophageal reflux disease symptoms have a prevalence of 10–20% in Western countries and are associated with obesity, smoking, oesophagitis, chest pain and respiratory disease.Aim : To determine the natural history of gastro-oesophageal reflux disease presenting in primary care in the UK.Methods : Patients with a first diagnosis of gastro-oesophageal reflux disease during 1996 were identified in the UK General Practice Research Database and compared with age- and sex-matched controls. We investigated the incidence of gastro-oesophageal reflux disease, potential risk factors and comorbidities, and relative risk for subsequent oesophageal complications and mortality.Results : The incidence of a gastro-oesophageal reflux disease diagnosis was 4.5 per 1000 person-years (95% confidence interval: 4.4–4.7). Prior use of non-steroidal anti-inflammatory drugs, smoking, excess body weight and gastrointestinal and cardiac conditions were associated with an increased risk of gastro-oesophageal reflux disease diagnosis. Subjects with gastro-oesophageal reflux disease had an increased risk of respiratory problems, chest pain and angina in the year after diagnosis, and had a relative risk of 11.5 (95% confidence interval: 5.9–22.3) of being diagnosed with an oesophageal complication. There was an increase in mortality in the gastro-oesophageal reflux disease cohort only in the year following the diagnosis.Conclusions : Gastro-oesophageal reflux disease is a disease associated with a range of potentially serious oesophageal complications and extra-oesophageal diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2004.02169.x
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  • 3
    Electronic Resource
    Electronic Resource
    Discordance between the degree of osteopenia and the prevalence of spontaneous vertebral fractures in Crohn's disease (2002)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 16 (2002), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : A high prevalence of osteoporosis has been noted in Crohn's disease, but data about fractures are scarce.Methods : The relationship between low bone mineral density and the prevalence of vertebral fractures was studied in 271 patients with ileo-caecal Crohn's disease in a large European/Israeli study. One hundred and eighty-one currently steroid-free patients with active Crohn's disease (98 completely steroid-naive) and 90 steroid-dependent patients with inactive or quiescent Crohn's disease were investigated by dual X-ray absorptiometry scan of the lumbar spine, a standardized posterior/anterior and lateral X-ray of the thoracic and lumbar spine, and an assessment of potential risk factors for osteoporosis.Results : Thirty-nine asymptomatic fractures were seen in 25 of 179 steroid-free patients (14.0%; 27 wedge, 12 concavity), and 17 fractures were seen in 13 of 89 steroid-dependent patients (14.6%; 14 wedge, three concavity). The prevalence of fractures in steroid-naive patients was 12.4%. The average bone mineral density, expressed as the T-score, of patients with fractures was not significantly different from that of those without fractures (−0.759 vs. −0.837; P=0.73); 55% of patients with fractures had a normal T-score. The bone mineral density was negatively correlated with lifetime steroids, but not with previous bowel resection or current disease activity. The fracture rate was not correlated with the bone mineral density (P=0.73) or lifetime steroid dose (P=0.83); in women, but not in men, the fracture rate was correlated with age (P=0.009).Conclusions : The lack of correlation between the prevalence of fractures on the one hand and the bone mineral density and lifetime steroid dose on the other necessitates new hypotheses for the pathogenesis of the former.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2002.01317.x
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  • 4
    Electronic Resource
    Electronic Resource
    The role of the gut flora in health and disease, and its modification as therapy (2002)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 16 (2002), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The gut flora is a vast interior ecosystem whose nature is only beginning to be unravelled, due to the emergence of sophisticated molecular tools. Techniques such as 16S ribosomal RNA analysis, polymerase chain reaction amplification and the use of DNA microarrays now facilitate rapid identification and characterization of species resistant to conventional culture and possibly unknown species. Life-long cross-talk between the host and the gut flora determines whether health is maintained or disease intervenes. An understanding of these bacteria–bacteria and bacteria–host immune and epithelial cell interactions is likely to lead to a greater insight into disease pathogenesis. Studies of single organism–epithelial interactions have revealed the large range of metabolic processes that gut bacteria may influence. In inflammatory bowel diseases, bacteria drive the inflammatory process, and genetic predisposition to disease identified to date, such as the recently described NOD2/CARD15 gene variants, may relate to altered bacterial recognition. Extra-intestinal disorders, such as atopy and arthritis, may also have an altered gut milieu as their basis. Clinical evidence is emerging that the modification of this internal environment, using either antibiotics or probiotic bacteria, is beneficial in preventing and treating disease. This natural and apparently safe approach holds great appeal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2002.01310.x
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  • 5
    Electronic Resource
    Electronic Resource
    Elevated plasma levels of noradrenaline in duodenal ulcer (1983)
    Springer
    World journal of surgery 7 (1983), S. 385-389 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les modifications de la concentration dans le plasma de la catécholamine et de la gastrine ainsi que les modifications de la secrétion d'acide gastrique après repas d'épreuve simulé ont été étudiées chez 7 malades atteints d'ulcère duodénal avant la vagotomie hypersélective et 6 semaines après celle-ci. La sécrétion basale et le pic de la sécrétion acide furent réduits après la vagotomie hypersélective. Les concentrations de la noradrénaline plasmatique qui étaient élevées chez les ulcéreux revirent à la normale après l'intervention. En revanche, les taux de l'adrénaline plasmatique qui étaient voisins de la normale avant l'intervention ne varièrent pas après celle-ci. Les taux de la gastrine plasmatique furent sensiblement plus élevés après la vagotomie hypersélective. Cette étude permet d'affirmer que le repas d'épreuve simulée ne produit pas de modification significative des taux de la catécholamine et de la gastrine plasmatique avant ou après vagotomie hypersélective, mais, en revanche, l'intervention est suivie de la diminution du taux de la noradrénaline. On peut conclure de l'ensemble de ces faits que la noradrénaline est impliquée dans la genèse de la maladie ulcéreuse ou qu'elle en constitue le reflet.
    Abstract: Abstracto Los cambios en las concentraciones plasmáticas de catecolamina y de gastrina y en la secreción de ácido gástrico en respuesta a una comida fantasma (sham feeding), fueron investigados en 7 pacientes con Úlcera duodenal (DU) antes y 6 semanas después de vagotomía altamente selectiva (HSV). Tanto la secreción basal como la secreción pico en respuesta a una comida fantasma modificada, fueron reducidas en forma significativa por la HSV. Las concentraciones plasmáticas de noradrenalina se encontraban elevadas en pacientes con UD, pero descendieron a valores normales después de HSV. Las concentraciones plasmáticas de adrenalina estuvieron dentro de límites normales y no cambiaron después de HSV. Las concentraciones basales de gastrina se hallaron significativamente más altas después de HSV que antes. La comida fantasma modificada no causó cambios significativos en las concentraciones plasmáticas de catecolamina y de gastrina, ni pre ni postoperatoriamente. Se concluye que la noradrenalina está involucrada en, o es un reflejo de la enfermedad ulcerosa duodenal.
    Notes: Abstract The changes in plasma catecholamine and gastrin concentrations and gastric acid secretion in response to modified sham feeding were investigated in 7 duodenal ulcer (DU) patients before and 6 weeks after highly selective vagotomy (HSV). Both basal and peak acid secretion in response to modified sham feeding were significantly reduced by HSV. Basal plasma noradrenaline concentrations were elevated in DU patients but fell to normal values after HSV. Plasma adrenaline concentrations were within the normal range and did not change after HSV. Basal gastrin concentrations were significantly higher after HSV than before. Modified sham feeding caused no significant changes in plasma catecholamine and gastrin concentrations either pre- or postoperatively. It is concluded that noradrenaline is involved in, or reflects, DU disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01658088
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  • 6
    Electronic Resource
    Electronic Resource
    The anti-ulcer drug sucralfate does not affect gastric nicotine levels (1996)
    Springer
    European journal of clinical pharmacology 49 (1996), S. 511-513 
    Details
    ISSN: 1432-1041
    Keywords: Intragastric nicotine ; Peptic ulcer ; Sucralfate ; smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: It has been claimed that sucralfate can overcome the negative effects of nicotine in patients with peptic ulcer disease, although the possible mechanism being unknown. This study was performed in order to test whether sucralfate was capable of binding intragastric nicotine, thus making it impossible for the substance to exert effect. Method: Nicotine was administered via transdermal patches or as capsules yielding gastric concentrations of 40–2980 ng·ml−1. Gastric juice aspirates (n=9) were incubated with sucralfate, which was then separated by centrifugation, and the nicotine concentration was compared in incubated and non-incubated samples. Results: A median decrease of 13% (range 0–27%) in nicotine concentration was seen after incubation with sucralfate (P=0.01). Conclusion: The binding of nicotine to the precipitating agent sucralfate is not sufficient effectively to remove nicotine from the gastric juice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00195939
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  • 7
    Electronic Resource
    Electronic Resource
    The anti-ulcer drug sucralfate does not affect gastric nicotine levels (1996)
    Springer
    European journal of clinical pharmacology 49 (1996), S. 511-513 
    Details
    ISSN: 1432-1041
    Keywords: Key words Intragastric nicotine ; Peptic ulcer ; Sucralfate; smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: It has been claimed that sucralfate can overcome the negative effects of nicotine in patients with peptic ulcer disease, although the possible mechanism being unknown. This study was performed in order to test whether sucralfate was capable of binding intragastric nicotine, thus making it impossible for the substance to exert effect. Method: Nicotine was administered via transdermal patches or as capsules yielding gastric concentrations of 40–2980 ng ⋅ml−1. Gastric juice aspirates (n = 9) were incubated with sucralfate, which was then separated by centrifugation, and the nicotine concentration was compared in incubated and non-incubated samples. Results: A median decrease of 13% (range 0–27%) in nicotine concentration was seen after incubation with sucralfate (P = 0.01). Conclusion: The binding of nicotine to the precipitating agent sucralfate is not sufficient effectively to remove nicotine from the gastric juice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002280050058
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  • 8
    Electronic Resource
    Electronic Resource
    Transdermally administered nicotine accumulates in gastric juice (1996)
    Springer
    European journal of clinical pharmacology 51 (1996), S. 315-318 
    Details
    ISSN: 1432-1041
    Keywords: Key words Gastric juice; nicotine ; ion-trapping ; peptic ulcer disease ; smoking cessation ; transdermal patch ; saliva
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Methods: Transdermal nicotine patches (Nicorette® 15 mg ⋅ 16 h–1) were administered to 7 healthy volunteers. Nicotine concentrations in gastric juice were monitored for 8 h via a naso-gastric tube and so was nicotine in saliva and plasma. Results: Nicotine accumulated in gastric juice, the average concentration being 60.6-times higher than in plasma. In saliva, too, the concentration was higher than in plasma, the average ratio being 10.5. These results strongly suggested ion-trapping of nicotine base in the acidic gastric juice and possibly also in the acinar cells, followed by active secretion. It is hypothesised that accumulation in saliva occurs via a similar mechanism. Pretreatment with omeprazole did not increase the pH to a sufficiently high degree to test the hypothesis that the accumulation of nicotine in gastric juice was pH dependent. Conclusions: Transdermal administration of nicotine produced a high intragastric concentration. The clinical consequence of this effect of long-term nicotine replacement therapy during smoking cessation is unclear.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002280050204
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  • 9
    Electronic Resource
    Electronic Resource
    A financial analysis of laparoscopic and open cholecystectomy (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 702-705 
    Details
    ISSN: 1432-2218
    Keywords: Costs ; Laparoscopic cholecystectomy ; Open cholecystectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Laparoscopic cholecystectomy (LC) is now the method of choice in treatment of symptomatic gallstone disease. Despite its rapidly growing popularity, comparative costs of this new method and open cholecystectomy (OC) remain unclear. The most outstanding feature of laparoscopic cholecystectomy is the period of short recovery. In Sweden the social insurance office documents sick leave period, sickness allowance, as well as diagnosis and therefore provides a reliable basis for an economic analysis. The purpose of this study was to estimate the hospital cost and costs due to sick leave in a series of patients operated on with elective cholecystectomy using the two methods. In each group 50 consecutive patients were studied retrospectively. The total hospital cost was 10% lower in the laparoscopy group—$1,864 as compared to $2,030 per patient in the OC group. Median number of days off work was 14 after LC and 35 days after open surgery, which corresponds to a median sickness allowance of $516 per patient (LC) compared to $1,424 (OC). Laparoscopic cholecystectomy is more cost-effective than open cholecystectomy mainly due to a reduced sick leave period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187944
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  • 10
    Electronic Resource
    Electronic Resource
    Acute Effects of High-Dose Intragastric Nicotine on Mucosal Defense Mechanisms An Analysis of Nicotine, Prostaglandin E2, Phospholipase A2, and Phospholipids (1997)
    Springer
    Digestive diseases and sciences 42 (1997), S. 640-644 
    Details
    ISSN: 1573-2568
    Keywords: CYTOPROTECTION ; NICOTINE ; PEPTIC ULCER ; PHOSPHOLIPASE A2 ; PHOSPHOLIPIDS ; PROSTAGLANDIN E2 ; SMOKING
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Peptic ulcer disease is overrepresented amongsmokers; they also heal slowly and relapse frequently.Data are accumulating that smoking is detrimental togastroduodenal mucosal cytoprotection. This study was designed to assess acute effects ofhigh-dose intragastric nicotine, as it has been shownthat nicotine is accumulated in gastric juice whensmoking. Seven healthy smokers were given nicotine base(6 mg) as tablets, which yielded very highintragastric concentrations and plasma levels comparableto those seen when smoking. In addition to nicotineanalysis, concentration levels of prostaglandinE2 (PGE2), phospholipase A2 (PLA2),and phospholipid classes were measured before and afternicotine administration. Nicotine inhibitedPGE2 levels by 27-81%, whereasPLA2 and total phospholipids were unaffected. Lysolecithin, a degradation product of the mainconstituent of gastric surfactant, i.e.,phosphatidylcholine, tended to increase, but this wasnot reflected in intragastric phosphatidylcholinelevels. In conclusion, nicotine acutely inhibitsPGE2 and may thus impair mucosalcytoprotection. The present findings do not imply acentral role of surface-active phospholipids withrespect to nicotine and gastric cytoprotection, but the chronic effects ofnicotine remain to be investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018823815665
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