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  • 1
    Electronic Resource
    Electronic Resource
    Gastric and duodenal mucosal blood flow in patients receiving non-steroidal anti-inflammatory drugs—influence of age, smoking, ulceration and Helicobacter pylori (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 7 (1993), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Using laser Doppler flowmetry, we measured gastric and duodenal mucosal blood flow in 70 patients who had taken non-steroidal anti-inflammatory drugs (NSAIDs) for longer than 4 weeks, and studied the correlation with demographic factors, ulceration, and Helicobacter pylori. Blood flow was also measured in 17 other subjects not taking any drugs. Measurements were taken from healthy-looking mucosa in the gastric antrum and the first part of the duodenum.Both gastric and duodenal blood flow values were significantly lower in patients taking NSAID than in those who did not. In the NSAID group, the median duodenal mucosal blood flow was 150 perfusion units in smokers (n = 29) compared with 175 in non-smokers (P= 0.024), 123 units in patients with duodenal ulcers (n = 12) compared with 160 in those without duodenal ulcers (P= 0.020), 135 units in patients with H. pylori (n= 30) compared with 168 in patients without H. pylori (P= 0.033), and 118 in smokers infected with H. pylori compared with 175 units in non-smokers not infected with H. pylori (F= 13.4, P = 0.0005). There was no correlation with age. Gastric blood flow was not significantly influenced by any of the above variables.These results suggest that chronic NSAID intake is associated with reduced blood flow in both the stomach and duodenum. However, amongst NSAID patients, duodenal, but not gastric, mucosal blood flow is reduced in smokers, and in those with duodenal ulcers and H. pylori. Multivariate analysis showed that only the simultaneous presence of smoking and H. pylori had an independent suppressive effect, and when combined, lower blood flow values are observed which might suggest a synergistic relationship between these two factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1993.tb00067.x
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  • 2
    Electronic Resource
    Electronic Resource
    Review article: dietary and nutritional management of Crohn's disease (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 5 (1991), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The value of dietary alteration and the nutritional management of Crohn's disease is assessed in this review.Lactose restriction, low-fat diets and low-residue diets may be of value in specifically indicated clinical situations. A fibre-rich, unrefined carbohydrate diet has not been shown to alter the course of the disease, and the value of ‘exclusion diets’remains to be confirmed in controlled, prospective studies.Nutritional insufficiency of varying degrees is common in Crohn's disease and can be corrected by the efficient use of enteral diets (usually with polymeric preparations) or intravenous nutritional support. Growth retardation in adolescents with Crohn's disease can usually be improved by enteral nutrition.Nutritional support of various kinds may be of value in the management of local complications of Crohn's disease; sub-acute obstruction, anal, perianal and rectal lesions, fistulas and ileostomy complications, and the management of bile acid-induced diarrhoea.The use of nutrition as ‘primary therapy; in Crohn's disease is considered. Theoretical reasons why nutritional support and bowel rest may possibly induce remission of the disease are discussed. The evidence to date suggests that intravenous nutrition and bowel rest may not be effective in inducing a primary remission of the disease, and the possible value of elemental diets and polymeric diets in this respect are assessed. Further prospective controlled studies of elemental diets as primary therapy in Crohn's disease are required.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1991.tb00023.x
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  • 3
    Electronic Resource
    Electronic Resource
    Inhibition of human gastric cyclic AMP production by Helicobacter pylori protein—possible involvement of mucosal prostaglandin E2 (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 5 (1991), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effect of Helicobacter pylori protein on cAMP and prostaglandin (PGE2) production was studied in incubates of human gastric fundic mucosa.At 24 hours, specimens incubated in the control fluid had a median cAMP value of 81 pmol/mg protein, compared to 28 pmol/mg (P 〈 0.05) when incubated in H. pylori protein, 155 pmol/kg (P 〈 0.006) in histamine, and 23 pmol/kg (P 〈 0.05) in histamine plus H. pylori protein. A similar trend was observed at 48 hours. Although H. pylori protein had no direct effect on mucosal PGE2, it intensified the inhibitory effect of indomethacin and prevented the stimulatory effect of histamine on both PGE2 and cAMP production.Given the role of cAMP in various physiological responses, these results suggest that H. pylori protein might alter those functional aspects of the human gastric mucosa which rely on cAMP as a second messenger. Assuming that PGE2 is involved in mediating such effect, its role would appear to be either partial or indirect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1991.tb00041.x
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  • 4
    Electronic Resource
    Electronic Resource
    The interaction between Helicobacter pylori culture filtrate and indomethacin: effects on the integrity of human gastric antral mucosa and its prostaglandin E2 production in vitro (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 4 (1990), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Histopathological methods and radioimmunoassay were used to assess the microstructure and prostaglandin E2 production by paired specimens of human gastric antral mucosa; the specimens were studied after 48 h of incubation in base-line tissue culture medium, Helicobacter pylori culture filtrate, H. pylori culture control fluid, indomethacin, and H. pylori culture filtrate plus indomethacin. When applied alone, the filtrate did not affect the structure of the mucosal tissue or its prostaglandin E2 synthesis. In the overall group (n = 21), specimens incubated with the mixture of H. pylori filtrate and indomethacin had a median histological grade of 1 and prostaglandin E2 of 29 pg/mg tissue, compared to 2 pg/mg (P= 0.04) and 60 pg/mg (P= 0.0007) respectively, in specimens incubated with indomethacin alone.These results indicate that an interaction may exist between
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1990.tb00471.x
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  • 5
    Electronic Resource
    Electronic Resource
    Protection from gastrointestinal side-effects by azapropazone by its incorporation into a glucose—sodium acid citrate formulation (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 5 (1991), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Addition of glucose and sodium citrate to azapropazone, in proportions of 1:1:1 by weight reduced gastric mucosal damage in rats and there was a trend towards reduction in radiolabelled faecal red cell loss in human volunteers compared with that with azapropazone alone. The glucose and citrate did not affect the pharmacokinetics of azapropazone, or its therapeutic efficacy. While no difference was observed in endoscopic injury and in symptomatic gastrointestinal complaints in a multicentre comparison in rheumatic patients, a striking reduction in symptoms was observed in those patients with a history of severe gastrointestinal intolerance to non-steroidal anti-inflammatory drugs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1991.tb00046.x
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  • 6
    Electronic Resource
    Electronic Resource
    Replacing the acetyl linkage in aspirin with choline and magnesium moieties reduces the occurrence of gastric mucosal injury (1987)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 1 (1987), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The acetyl moiety in aspirin (acetyl salicylic acid: ASA) is considered to play a major part in the pathogenesis of ASA-induced mucosal injury. At equivalent salicylate doses and pH values, the induction of acute gastric mucosal haemorrhagic erosions in rats by ASA and choline magnesium trisalicylate (CMT), a new non-acetylated salicylate, with and without the potentiating damaging effect of taurodeoxycholic acid (TDCA) were compared. Test solutions were administered by per oral intubation to five groups of fasting Sprague–Dawley rats (n= 24). Gastric mucosa were examined after 4 hours and mucosal injury assessed by a lesion-scoring system. The incidence and severity (median lesion scores with quartiles) of the lesions were 83% and 13 (7:20) respectively for ASA (128 mg kg−1) compared with 17% and 0 (0:0) for CMT (128 mg kg−1) (P 〈 0.001 and P 〈 0.001). TDCA increased mucosal damage to 100% and 29 (20:34) for ASA compared with 30% and 0 (0:4) for CMT (P 〈 0.001) and P 〈 0.001). Serum salicylate levels (median values of 1.4 for ASA and 1.5 mmol litre−1 for CMT) were not significantly different. It is concluded that replacing the acetyl moiety in ASA with choline and magnesium moieties reduces the ASA-induced mucosal injury, without affecting blood salicylate concentrations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1987.tb00606.x
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  • 7
    Electronic Resource
    Electronic Resource
    Endoscopic evaluation of etodolac and naproxen, and their relative effects on gastric and duodenal prostaglandins (1990)
    Springer
    Rheumatology international 10 (1990), S. 17-21 
    Details
    ISSN: 1437-160X
    Keywords: Etodolac Endoscopy ; Naproxen ; Gastrointestinal ; Ulcers ; Prostaglandins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Etodolac has been shown to have a favorable safety profile in short-term and long-term studies in both osteoarthritis (OA) and rheumatoid arthritis (RA). Two studies were conducted to further assess the gastrointestinal (GI) safety profile of this drug. These studies were designed to compare the therapeutic efficacy and upper GI effects of etodolac (600 mg/day) and naproxen (1000 mg/day) administered over 4 weeks in patients with active rheumatoid arthritis. In addition, the relative effects of the drugs on prostaglandin levels in the stomach and duodenum were assayed in one study. Fifteen [15] patients were included in each study and received either 300 mg b.i.d. of etodolac or 500 mg b.i.d. of naproxen. In both studies, endoscopic examinations were performed on day 1 of the study and again 4 weeks later. In the second study, at the time of each endoscopy, samples of gastric and duodenal mucosa were taken for histologic study and prostaglandin assay. Endoscopy results from the first study showed significant differences in favor of etodolac between the two treatment groups. In the second study more naproxen-treated patients had abnormal endoscopy results than did etodolac-treated patients. Results from prostaglandin assays in gastric and duodenal mucosa showed no overall suppression of gastric or duodenal prostaglandin levels for etodolac-treated patients in contrast to naproxen-treated patients, who showed suppression of PGE2 and PGI2. The results of these studies show that etodolac therapy caused less gastric and duodenal injury than naproxen and also support the theory that the GI safety of etodolac may be due to selective sparing of cytoprotective prostaglandins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02274751
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  • 8
    Electronic Resource
    Electronic Resource
    The effect of variations in positive end expiratory pressure on gas exchange in ventilated children with liver disease (1993)
    Springer
    European journal of pediatrics 152 (1993), S. 742-744 
    Details
    ISSN: 1432-1076
    Keywords: Mechanical ventilation ; Paediatric intensive care ; Positive end expiratory pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of varying the positive end expiratory pressure (PEEP) level during mechanical ventilation has been assessed in ten children with liver disease, mean age 3.8 years. PEEP was increased 3 cmH2O above the child's original (baseline) PEEP level and then decreased either by 3 cmH2O below the baseline or to 0 cmH2O. In all ten children increasing the PEEP above the baseline improved oxygenation; in the group overall the medianPaO2 increased from 90 mmHg to 97mmHg (P〈0.01). In eight of the ten children decreasing the PEEP level below the baseline resulted in a deterioration in oxygenation; in the group overall the medianPaO2 decreased from 91 mmHg to 82 mmHg (P〈0.05). Changes in PEEP levels, however, did not result in clinically significant alterations inPaCO2, heart rate or blood pressure. We conclude that modest increases in PEEP are well tolerated in children with liver disease and result in an improvement in oxygenation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01953990
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  • 9
    Electronic Resource
    Electronic Resource
    The effect of the synthetic prostaglandin analog 15 (R) 15 methyl-PGE2 methyl ester on gastric mucosal hemorrhage induced in rats by taurocholic acid and hydrochloric acid (1977)
    Springer
    Digestive diseases and sciences 22 (1977), S. 411-414 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The incidence of mucosal hemorrhage induced in rats by the oral administration of taurocholic acid (TCA) and hydrochloric acid (HCl) both singly and in combination was investigated. The effect of prostaglandin 15 (R) 15 methyl-PGE2 methyl ester (Me-PGE2) on the occurrence of hemorrhage induced by TCA with HCl was also studied. The incidence of hemorrhage induced by TCA (10 mM) alone and HCl (160 mM) alone was minimal and not different from that induced by the control solution. The combination of TCA (10 mM) and HCl (160 mM) produced bleeding in 67.7% of animals. The addition of 15 (R) 15 methyl-PGE2 methyl ester (9.9 μM, corresponding to 50 μg/Kg) significantly, reduced the incidence of hemorrhage induced by the combination of TCA with HCl from 67.7% to 31.3%. This suggests that this synthetic prostaglandin may be of value in conditions thought to be associated with reflux of bile into the stomach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01071887
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  • 10
    Electronic Resource
    Electronic Resource
    Gastroduodenal mucosal surface and luminal pH in gastric ulcer (1991)
    Springer
    Digestive diseases and sciences 36 (1991), S. 1543-1549 
    Details
    ISSN: 1573-2568
    Keywords: cytoprotection ; endoscopy ; gastric ulcer ; mucosal surface pH
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastroduodenal mucosal surface pH was measuredin situ by electrode in endoscopically normal and gastric ulcer patients. With the exception of the antrum, mucosal surface pH in the ulcer group (GU) resembled that of the endoscopically normal group. In contrast, the antral mucosal surface pH of the GU group of 7.06±0.11 (22) was significantly (P〈0.001) higher than that of 5.46±0.36 (34) for the endoscopically normal group. This difference was also evident when comparison was restricted to subjects in both groups having a fundal luminal fluid pH of less than 3. When the fundal luminal pH was below pH 3, antral mucosal surface pH was 4.79±0.41 (24) in endoscopically normal subjects and significantly less (P〈0.001) than the value of 6.98±0.18 (12) for gastric ulcer patients. Mucosal surface alkalinity of the GU antrum may be a response to damage but seems inappropriate in view of the likelihood of acid dependent inhibition of gastric acid secretion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01296395
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