摘要:

SUMMARYThe Acquired Immune Deficiency Syndrome (AIDS) is frequently associated with infections, infestations, or diseases of the gastrointestinal tract. This review describes the practical aspects of treating oral and oesophageal disease, the management of weight loss and diarrhoea, the role for zidovudine, and the management of Kaposi's sarcoma.

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00478.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYThe mechanism for secretin‐induced gastrin release in the Zollinger‐Ellison syndrome is uncertain. We evaluated whether the stimulatory effect of intravenous secretin on gastrin release was partly mediated through a beta‐adrenergic stimulatory mechanism. Serum gastrin concentrations and heart rate were monitored in six patients with the Zollinger‐Ellison syndrome. Secretin (2 clinical units/kg) increased mean serum gastrin concentrations from 1558 pg/ml basally to a peak of 3683 pg/ml (136% above baseline). This increase was not altered by pretreatment with 2 mg of propranolol intravenously, a dose which in previous studies blocked terbutaline‐induced gastrin release. Secretin increased heart rate by 14 beats/min (20% above base‐line) and this also was not altered by propranolol pretreatment. Thus, the stimulatory effects of secretin on gastrinoma cells and the heart do not appear to be mediated by beta‐adrener

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00479.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYIn a prospective open study, 15 patients with ulcerative colitis which was unresponsive to conventional therapy were treated with enemas containing bismuth subsalicylate (700 or 800 mg b.d.).Nine out of the 15 patients showed a significant clinical response, and 6 had gone into complete clinical remission after 8 weeks. treatment. Sigmoidoscopic appearances of the rectal mucosa showed improvement in 9 out of 15 patients at 2 weeks, and 11 out of 15 at 8 weeks. The mucosa appeared sigmoidoscopically normal in 6 out of 15 at 8 weeks. It proved possible to reduce the oral prednisolone dosage from a median of 15 mg/day (range 10 to 35 mg/day) to 6 mg/day (range 0 to 18 mg/day) after 8 weeks of treatment; 5 patients were no longer taking oral steroids at this time.Rectal bismuth subsalicylate appears likely to be an effective therapy in ulcerative colitis and controlled trials are now required.

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00480.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYOne hundred and twenty patients with gastric ulcer disease, who had been receiving maintenance treatment with ranitidine (150 or 300 mg/day) for periods up to 7 years, were studied retrospectively. The proportion of patients remaining free from symptomatic recurrence of ulcer during maintenance treatment was 97% after 1 year; 90% after 3 years; and 79% after 5 years. No patient developed haemorrhage or perforation during maintenance treatment. None of the demographic features was shown to be associated with a significantly increased risk of ulcer recurrence during maintenance treatment.Comparison of the recurrence rates during maintenance treatment with those during periods without active anti‐ulcer therapy, using life table and incidence density analysis, showed a significant difference in favour of maintenance treatment.We conclude that maintenance treatment with ranitidine for 5 years significantly reduces the risk of symptomatic ulcer recurrence in patients with gastric ulce

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00481.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYOxidant stress has been proposed as the initiating pathogenetic mechanism in pancreatitis, hence micronutrient antioxidant therapy has been assessed in patients with recurrent attacks and/or constant pancreatic pain. In a 20‐week double‐blind double‐dummy crossover trial active treatment was given as two types of tablets providing daily doses of 600 μg organic selenium, 9000 IU β carotene, 0.54 g vitamin C, 270 IU vitamin E and 2 g methionine. Of 28 patients enrolled, 20 adhered to the full protocol (idiopathic chronic 8, alcoholic chronic 7, idiopathic acute 5). Six patients had an attack whilst on placebo but none whilst on active treatment (P= 0.032). Analysis of visual analogue scoresheets to compare background pain in the 10‐week period before entry and during each phase of the trial, using a 10‐cm scale for each of 11 best descriptors, endorsed the beneficial effect of active treatment (placebo v baseline,P= 0.073; active v baseline,P<0.001; active v placebo,P= 0.049). The same trend emerged from analysis of pain‐score diaries by conventional and time series methods. Micronutrient antioxidant therapy thus offers a new approach to the treatment of recurrent (non‐gallstone) pancreatitis and/or

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00482.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYPentagastrin stimulated gastric secretion was measured in 12 healthy male subjects after repeated once daily oral administration of 20 and 40 mg BY 1023/SK&F 96022 – a new substituted benzimidazole derivative.Twenty milligrams inhibited acid output compared with placebo by 24% (2.5–3.5 h) and 26% (24.5–25.5 h) after the first oral intake. Inhibition increased to 56% and 50%, respectively, after the seventh oral dose. Forty milligrams inhibited acid output by a mean of 51% (2.5 to 3.5 h) and 52% (24.5–25.5) after the first oral intake. After the seventh dose mean inhibition rose to 85% and 66%, respe

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00483.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYFifty asymptomatic patients with duodenal ulcer disease, aged 31–82 years, who had received ranitidine maintenance therapy continuously for five or more years without a symptomatic recurrence, were studied. Fasting plasma gastrin concentrations were normal (mean 24 pmol/L, S.D. ± 22) while the post‐prandial gastrin response was variable with maximum plasma concentrations ranging from 16 to 309 pmol/L. Endoscopy revealed six asymptomatic peptic ulcers. Histological examination of gastric biopsies showed mild, superficial inflammatory cell infiltration of the fundic mucosa, but more extensive inflammatory cell infiltration with some atrophy of the mucosal glands in the antral mucosa. Patchy intestinal metaplasia was evident in the antral mucosa of 18 patients. No fundic ECL cell hyperplasia was seen.Helicobacter pyloriwere detected in the corpus and antrum of most patients. These results suggest that maintenance treatment with ranitidine for 5 years is not associated with either significant hypergastrinaemia or with changes in the fundic mucosa which could be interpreted as pre‐mal

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00484.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYA total of 131 patients undergoing upper gastrointestinal endoscopy were sedated with midazolam given as a bolus injection over 5 seconds. The oxygen saturation was continuously measured using a pulse oximeter. Supplemental oxygen was given via nasal cannulae at a rate of 3 litres per minute to 54 patients, while the remaining 77 patients only received oxygen if their oxygen saturation dropped below 85%. Both groups in the present series were compared with 3 previously published series of patients, in whom we had used intravenous midazolam as a slow titrated injection.Despite using on average only two‐thirds of the dose of midazolam, following bolus injection the degree of oxygen desaturation during the endoscopic procedure was greater, and the ability of supplemental oxygen delivered via nasal cannulae to prevent hypoxia was less (P<0.01), than with a slow titrated injectio

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00485.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYThe effect of duodenal ulcer healing on the acid secretory responses to modified sham feeding and maximal pentagastrin stimulation has been studied in 17 patients treated successfully with ranitidine (n= 9) and sucralfate (n= 8). Parietal cell sensitivity was calculated as the ratio of the modified sham feeding response to the peak pentagastrin response, expressed as a percentage. Ulcer healing after sucralfate therapy resulted in significant falls in modified sham feeding stimulated acid output (P<0.02), from 9.4 (1.8–17.0) (median + range) to 3.7 (0.2–9.4) mmol/h; in peak acid output (P<0.05) from 42.8 (23.0–61.4) to 27.7 (7.2–51.0)mmol/h; and in the parietal cell sensitivity (P<0.05) from 19.2 (4.4–42.6) to 14.3 (2.8–19.7)%. No significant falls in any of these parameters were noted following ulcer healing with ranitidine. Duodenal ulcer healing with sucralfate results in decreased acid secretory responses to vagal and pentagastrin

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00486.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYCalcium antagonists relax smooth muscle, a possible useful concept in treatment of diffuse oesophageal spasm. Therefore the effects of oral diltiazem (60 mg t.d.s.) and placebo were compared in eight patients with diffuse oesophageal spasm in a 10‐week double‐blind crossover study. The patients recorded the severity of chest pain and/or dysphagia in daily pain diaries using visual analogue scales. Chest pain index and dysphagia index were calculated by multiplying frequency with daily intensity of each individual symptom. When compared to placebo, diltiazem did not significantly change the overall dysphagia index and chest pain index. An individual sizeable reduction of dysphagia was attained on diltiazem in four out of six patients and in six out of eight patients suffering from chestpain. Side effects were not seen during diltiazem therapy. Diltiazem, in our study, did not yield in a significant improvement of symptoms in diffuse oesophageal spasm. Diltiazem, however, can offer relief in selected individual patients suffering from diffuse oesophageal sp

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00487.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY