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  • 1
    Electronic Resource
    Electronic Resource
    Dose-dependent stimulation of gallbladder contraction by intravenous erythromycin in man (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: We have previously shown that a single oral dose of 500 nig erythromycin causes gallbladder contraction. The effect of intravenous erythromycin on antroduodenal motility is dose-dependent; 〈 3 mg/kg body weight stimulates propagated contractions in a fashion similar to motilin while doses 〉 7 mg/kg cause giant non-propagated antral contractions not seen with motilin. Using ultrasound, we have examined the effect of differing doses of intravenous erythromycin on gallbladder motility in man. Erythromycin (1 mg/kg) caused fasting gallbladder contraction to 52 % of basal gallbladder volume (P 〈 0.001), and increased gallbladder emptying following a liquid meal (maximal percentage emptied 75 ± 6.8% vs. 58 ± 9.0% following saline, P 〈 0.05). Erythromycin (7 mg/kg) however, had no effect on gallbladder fasting or post-prandial motor activity. We conclude that the effect of erythromycin on gallbladder motility is dose-dependent, with higher doses having no effect. It is possible that at higher doses erythromycin stimulates other receptors in addition to the motilin receptor, and that the combined effect is different to the stimulation of the motilin receptor alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1993.tb00069.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    A new model of human secretory diarrhoea using cholera toxin (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 6 (1992), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Secretory diarrhoea is a major cause of morbidity and mortality worldwide. However, there is no biologically relevant test system in man for assessing new anti-diarrhoeal therapies prior to clinical trial. We have used highly purified cholera toxin in combination with the triple lumen jejunal perfusion technique to establish a subclinical model of cholera in man. Cholera toxin was administered either by mouth with sodium bicarbonate or directly into a 30 cm‘open’ or‘closed’(isolated between two inflated balloons) jejunal segment in healthy adult volunteers. Both oral dosing and direct delivery into an‘open’ jejunal segment failed to produce consistent secretion of water and electrolytes. In contrast 15 μg or 25 μg of cholera toxin elicited secretion of water and sodium 3 h after instillation into the balloon occluded‘closed’ jejunal segment (P 〈 0.05 vs. controls). The rate of secretion was constant over the maximal period studied (4.5 h) and was similar to that reported in human cholera. None of the subjects experienced troublesome diarrhoea. We believe this model offers a relevant test system for assessing anti-diarrhoeal therapy in man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1992.tb00576.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    A double-blind randomized trial of low-dose versus high-dose topical anaesthesia in unsedated upper gastrointestinal endoscopy (1996)
    Oxford BSL : Blackwell Science
    Alimentary pharmacology & therapeutics 10 (1996), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Upper gastrointestinal endoscopy is frequently performed on unsedated subjects. Pharyngeal anaesthesia is thought to improve patient tolerance to the procedure but the optimum dose of anaesthesia is not known. The aim of this study was to assess the benefits of low-dose vs. high-dose topical anaesthesia in unsedated gastroscopy. Methods: One hundred and fourteen subjects attending for diagnostic gastroscopy were studied. Patients were randomized to receive either 30 mg or 100 mg of topical pharyngeal lidocaine spray prior to endoscopy in a double-blind fashion. Subjects completed a questionnaire before and after endoscopy. Results: A similar proportion of patients in each group required intravenous sedation because of discomfort or anxiety during the procedure (P=0.48). The high-dose group experienced less discomfort during endoscope insertion (P=0.002) and throughout the examination (P=0.01). Overall satisfaction was almost identical in the two groups (P=0.85) and a similar percentage of the high-dose and low-dose groups stated that they would request sedation prior to future endoscopy (37 vs. 44%; P=0.48). Further analysis showed that apprehensive patients and younger patients reported relatively high levels of discomfort, and that female subjects were more likely to express a preference for sedation at any future gastroscopy. Conclusion: High-dose pharyngeal anaesthesia reduces patient discomfort during unsedated upper gastrointestinal endoscopy. However, patient tolerance is also influenced by clinical features, which might be useful in deciding which patients are suitable for this procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1996.89261000.x
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Changing patterns of sedation use for routine out-patient diagnostic gastroscopy between 1989 and 1998 (2001)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 15 (2001), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Knowledge of sedation trends for upper gastrointestinal endoscopy is important for health service planning, particularly in view of rapidly increasing demands on endoscopy services. However, no data are available on sedation trends in Britain over the past 10 years.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To determine sedation use for routine gastroscopy in a single endoscopy unit between 1989 and 1998.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:This was a retrospective study of 9795 consecutive adults (mean age 56 years, range 18–100 years; 4512 females) who had undergone a gastroscopy between 1989 and 1998. Clinical, pharmacological and endoscopic data were retrieved from a computerized database.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Over the 10-year study period, the sedation rate remained constant for patients undergoing therapeutic endoscopy (P=0.99) and those undergoing in-patient diagnostic examinations (P=0.63). In contrast, the sedation rate for out-patient diagnostic endoscopy decreased by 54%, from a high of 70% in 1990 to 32% in 1998 (P 〈 0.0001). Logistic regression analysis showed that the decline in sedation use was greater in females (P 〈 0.0001) than males and in procedures performed by non-consultant compared to consultant staff (P=0.01).〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:If our results form part of a national trend, they will have important implications for cardiopulmonary monitoring strategies, recovery room practices and for complication rates due to the use of sedation for upper gastrointestinal endoscopy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2001.00912.x
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    Paper (German National Licenses)
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