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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 16 (1979), S. 31-34 
    ISSN: 1432-0428
    Keywords: Obesity ; glucose tolerance ; hypoglycaemia ; jejuno-ileal bypass ; insulin ; insulin antagonist ; gastrointestinal hormones ; gastrin ; glucagon ; gut-GLI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nine patients were studied 1.5–3 years after jejuno-ileostomy for obesity by an intravenous glucose infusion technique designed to imitate blood glucose concentrations after glucose ingestion. Whereas serum insulin and gastrin concentrations were normal, blood glucose concentrations were significantly depressed compared to preoperative levels as well as to levels in matched normal subjects. Thus, in the fasting state mean concentrations (± S.E.M.) of blood glucose, serum insulin and gastrin in the patients were, respectively, 3.3±0.2 mmol/l, 95±22 pmol/l and 38±4 pmol/l. The corresponding concentrations in the matched normals were 4.3±0.2 mmol/l, 70±18 pmol/l and 39±6 pmol/l. The glucose concentrations in the patients were low in all situations, i. e. in the fasting state, after oral glucose ingestion and during the intravenous glucose infusion. The results indicate that jejuno-ileostomy in obesity greatly facilitates peripheral glucose disposal. The mechanism behind this phenomenon is not yet known.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Gastric inhibitory polypeptide (GIP) ; control ofGIP ; plasma insulin ; insulin secretion ; plasma glucose ; enteroinsular axis ; fetal pigs ; neonatal pigs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The responses of gastric inhibitory polypeptide (GIP) and insulin to intraduodenal and IV triglyceride infusions were measured in 11 late fetal and 10 neonatal pigs. Basal plasma glucose, insulin, and GIP concentrations were lower in fetal than in neonatal pigs. In the fetal pigs, plasma glucose increased slightly during intraduodenal and IV triglyceride infusions, whereas plasma insulin remained unchanged during the tests. No significant changes were observed in plasma GIP concentration following intraduodenal triglyceride infusion in the fetal pigs, but plasma GIP fell during the IV infusion of triglyceride in these pigs (p〈0.01). In the neonatal pigs, plasma glucose and insulin remained unaffected by intraduodenal and triglyceride infusions. Plasma GIP did not change during the IV triglyceride infusion, but exhibited a paradoxical decline after the intraduodenal triglyceride infusion (p〈0.05). It is concluded that the GIP-cell response to an oral triglyceride load is suppressed in late fetal and neonatal pigs. The abolished GIP response to oral triglycerides could play a causal role in the inactivity of the enteroinsular axis which is seen in both human and animal neonates.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 14 (1978), S. 149-153 
    ISSN: 1432-0428
    Keywords: GIP ; insulin ; incretin ; duodenal ulcer ; oral glucose tolerance test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The response of Gastric Inhibitory Polypeptide (GIP) and insulin to a 50 g oral glucose tolerance test (OGTT) and an intravenous glucose infusion (IVGI), which copied the changes in plasma glucose concentrations during the OGTT, were measured in 10 patients with duodenal ulcer and in 10 healthy control subjects. The mean responses of GIP and insulin to OGTT were significantly increased in the ulcer patients. During IVGI the responses were normal. The degree of increased GIP response in the patients was positively correlated with the plasma glucose increase during the OGTT. It is postulated that the increased GIP secretion is related to a faster glucose absorption due to rapid gastric emptying in duodenal ulcer patients. No correlation was found between basal and peak gastric acid output and the GIP response in the patients. The data demonstrate that GIP secretion is not defective in duodenal ulcer patients.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Oral glucose tolerance ; insulin ; GIP ; myocardial infarction ; coronary artery disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Ten male patients, recovered from acute myocardial infarction, and ten control subjects were investigated by a 50 g oral glucose tolerance test. All patients and control subjects had normal glucose tolerance, but the patients had increased fasting and integrated insulin response to oral glucose. Fasting gastric inhibitory polypeptide concentrations and integrated gastric inhibitory polypeptide response were normal in the patients. The exaggerated insulin secretion in patients recovered from myocardial infarction does not seem to be caused by increased secretion of gastric inhibitory polypeptide.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Physica A: Statistical Mechanics and its Applications 202 (1994), S. 224-236 
    ISSN: 0378-4371
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cyclosporin 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.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 3 (1989), S. 0 
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: One-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.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Most patients with gastro-oesophageal reflux disease (GERD), regardless of endoscopic status, suffer symptomatic relapse within 6 months of stopping acid suppressant therapy.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To assess the efficacy of ‘on-demand’ treatment of GERD with esomeprazole, the first proton pump inhibitor developed as an optical isomer.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:In this multicentre, double-blind study, 342 endoscopy-negative GERD patients demonstrating complete resolution of heartburn during the final week of a 4-week treatment period with esomeprazole 20 mg or omeprazole 20 mg once daily were randomized to receive esomeprazole 20 mg or placebo on demand (maximum of one dose per day) for a further 6 months. Use of rescue antacids was permitted.〈section xml:id="abs1-4"〉〈title type="main"〉Results:All 342 patients (191 males), aged 19–79 (mean 49) years, were evaluable in the intention-to-treat analysis. The proportion of patients who discontinued treatment due to insufficient control of heartburn was significantly higher among placebo compared to esomeprazole recipients (51% vs. 14%; P 〈 0.0001). Patients randomized to esomeprazole on-demand therapy remained in the study longer than those in the placebo group (mean 165 vs. 119 days). Over 50% took the study medication for periods of 1–3 consecutive days (esomeprazole) or 4–13 consecutive days (placebo). Use of antacids was 〉 2-fold higher among placebo recipients. The frequency of adverse events was similar in the two groups, when adjusted for time spent in the study, as were the clinical laboratory profiles.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:On-demand therapy with esomeprazole 20 mg is effective and well tolerated in maintaining symptom control in endoscopy-negative GERD.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Prokinetic agents have shown variable efficacy in the treatment of functional dyspepsia. Mosapride is a new prokinetic 5-hydroxytryptamine-4 agonistic agent.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To evaluate the efficacy of three dosage regimens of mosapride compared with placebo in the treatment of functional dyspepsia.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:Patients were randomly allocated to treatment with placebo or mosapride (5 mg b.d., 10 mg b.d. or 7.5 mg t.d.s.) in a double-blind, prospective, multicentre, multinational study. The change in symptom severity score from an untreated baseline week to the sixth week of treatment was used to compare treatment efficacy.〈section xml:id="abs1-4"〉〈title type="main"〉Results:There were 141, 140, 143 and 142 patients valid for evaluation in the intention-to-treat population in the placebo, mosapride 5 mg b.d., mosapride 10 mg b.d. and mosapride 7.5 mg t.d.s. groups, respectively. The mean changes in the overall dyspeptic symptom score were – 0.90, – 0.94, – 0.88 and – 0.89, respectively, and the proportions of patients feeling better at the end of the treatment period were 60%, 59%, 59% and 61%, respectively. No statistically significant difference was seen.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Treatment of functional dyspepsia with mosapride was not superior to placebo. The result raises the question of whether treatment with prokinetic agents is appropriate for functional dyspepsia.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The efficacy of omeprazole in the treatment of endoscopy-negative reflux disease has been examined in five recently completed, multicentre, double-blind, randomized, parallel group studies. A total of 1959 patients with endoscopy-negative reflux disease took part in these trials in which 20 mg omeprazole once daily (n = 722) was compared with placebo (n = 304) and/or 10 mg omeprazole once daily (n = 624), 150 mg ranitidine twice daily (n = 213), or 10 mg cisapride four times daily (n = 96). In all studies, the primary outcome measures were assessed after 4 weeks of treatment.Absence of heartburn, defined as no episodes of heartburn during the fourth week of treatment, occurred in 14–29% of patients receiving placebo, 31% receiving cisapride, 35% receiving ranitidine, 31–60% receiving 10 mg omeprazole once daily, and 44–62% receiving 20 mg omeprazole once daily. Adequate control of heartburn, defined as only 1 day with episodes of mild heartburn during the seventh week of treatment, occurred in 24% of patients receiving placebo. 46% receiving cisapride, 46% receiving ranitidine, 49–60% receiving 10 mg omeprazole once daily, and 56–63% receiving 20 mg omeprazole once daily, on the basis of data from three of the studies. The differences between the two omeprazole doses and placebo, and between 20 mg omeprazole once daily, and either 10 mg omeprazole once daily, ranitidine or cisapride, were all statistically significant (P 〈 0.05). Diary cards for most patients who responded to omeprazole showed an absence of heartburn in the first week of treatment. Health-related quality of life was measured at baseline and after 4 weeks of treatment, using validated questionnaires (i.e. the Psychological General Well-Being Index and the Gastrointestinal Symptom Rating Scale). After 4 weeks of treatment, the general well-being of patients taking 10 or 20 mg omeprazole once daily had improved significantly (P 〈 0.05) compared with those taking placebo.In conclusion, 10 and 20 mg omeprazole once daily provides effective and rapid control of heartburn in patients with endoscopy-negative reflux disease. Absence of heartburn and adequate control of heartburn occur significantly more frequently in patients treated with 20 mg omeprazole once daily, compared with patients treated with 10 mg omeprazole once daily, 150 mg ranitidine twice daily, or 10 mg cisapride four times daily. Omeprazole also restores health-related quality of life, in terms of enhanced well-being, to the level observed in a healthy population.
    Type of Medium: Electronic Resource
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