Biomedical subjects
Publications and source records attributed to A Bettarello.
Small bowel bacterial growth was studied in patients with strongyloidiasis, and the results were compared to controls. We concluded that in strongyloidiasis there is small bowel bacterial overgrowth, and so it should be considered in the pathogenesis of some of the gastrointestinal manifestations and complications of strongyloidiasis.
Control male Wistar rats with intact bile circulation, animals with a bile duct-right ureter fistula, and bile duct-right ureter fistula rats fed taurocholic acid (5.5 mg/day) were maintained on a cholesterol-free pellet diet and pulse labeled subcutaneously with radioactive cholesterol. Bile acid feeding did not interfere with the synthesis of cholesterol by the intestinal mucosa or by the whole body in spite of markedly lowering the production of bile acids. Of the total fecal cholesterol mass in bile fistula animals roughly 25% originated from plasma filtration and 75% was ascribed to local mucosal cholesterol synthesis.
The ingestion of plain coffee was compared in 150 duodenal ulcer patients (DU) and 100 control subjects without digestive complaints (C). The DU and C groups were registered in accordance with their daily consumption of coffee: none, 1-100 ml, 101-300 ml, 301-500 ml, and more than 500 ml. Fifty millilitres of coffee as prepared in Brazil contain around 50 mg of a caffeine, which is 2.8 times more than in an equal volume of coffee in the United States. Patients with DU stopped drinking coffee or reduced the volume significantly after symptoms started. There was a significant change in coffee intake at all volume levels except at 1-100 ml. The main reason for the reduction of coffee ingestion was the relationship observed by the patients between the consumption of coffee and dyspeptic complaints. Our results suggest a close correlation between the ulcer-like symptoms and the amount of coffee ingested by patients with duodenal ulcer.
1. Survival time, amylase activity and pancreatic protein, DNA and RNA content were measured in 38 control rats and in 104 rats injected with sodium taurocholate to induce acute pancreatitis after 21 days on one of four diets differing in protein, lipid and carbohydrate content. 2. All of the parameters measured were lower in rats with pancreatitis than in controls maintained on the same diets. Among the rats with pancreatitis, those receiving a protein-free diet survived longer and had significantly higher DNA, lower amylase activity and lower RNA and protein levels than those receiving a balanced diet or one that was high in protein or lipid content. 3. We conclude that acute pancreatitis in rats has a more benign course in protein-undernourished animals.
In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by I.V. infusion, the plasma to lymph filtration of total protein, albumin, and cholesterol was similar after duodenal infusion of either long-chain (LCT) or medium-chain (MCT) triglyceride. Filtration of cholesterol into intestinal lacteals was also measured after pulsed I.V. administration of 14C-beta-sitosterol as an indirect marker for passage of lipoproteins into the lymph system. During intraduodenal administration of LCT and constant I.V. infusion of 125I-apo high density lipoprotein (HDL), intact plasma HDL appeared in lymph and contributed apo-LP to chylomicron formation. Nevertheless, most lymph apo-LP originated from local mucosal synthesis.
Famotidine was compared to ranitidine in a short-term study on the treatment of duodenal ulcer. Famotidine 20 mg. b.i.d., 40 mg. b.i.d. and 40 mg. nocte heal as many ulcer as ranitidine (90.9%, 91.7%, 83.3% and 100% respectively). A single 20 mg. bedtime dose shows to be effective on preventing ulcer recurrence for as long as 48 weeks; the 38% recurrence rate observed with famotidine was statistically different from the 78% observed with placebo. Diarrhoea was the most common complain observed during the short-term trial, followed by sleepiness and headache. The few and small biochemical alterations during the long-term treatment (increase in transaminases, alkaline phosphatase, glucose, BUN) could in no instance be directly related to the substances on use.
In 14 patients with alcoholic hepatitis an echographic study of the gallbladder was carried out. Nine subjects showed gallbladder wall thickening (thickness greater than 4 mm) and two a 'scanty content gallbladder'. These findings did not correlate with the serum albumin levels. The authors point out the similarity of these ultrasonographic findings with those described in patients with acute cholecystitis. Since the clinical characteristics of the two conditions may also be similar, the differentiation between them cannot be exclusively based on the gallbladder echographic appearance.
To examine previous work carried out at a single center, i.e., France, on the pathologic features of chronic pancreatitis and to examine geographic differences, 359 cases of chronic pancreatitis from five centers were studied pathologically and the results analyzed according to appropriate statistical methods. It was found that it was easy to separate chronic calcifying pancreatitis from obstructive pancreatitis occurring distal to obstruction to the pancreatic duct by pathological means. On the other hand, geographic differences between France, Italy, Brazil, and South Africa, although present, were not sufficient for identification of a specific profile for each of the countries studied, and it was found that the minor differences were probably dependent on environmental rather than racial factors.
Until 1950 the clinical treatment of peptic ulcer disease relied on dieting and antacids. However, recent controlled studies suggest that the natural course of peptic ulcer disease is not affected by diet. Antacids are primarily used to relieve distress, although high- and low-dose antacid regimens have been reported to promote duodenal ulcer healing. Initial favorable reports following the introduction of synthetic anticholinergic drugs have not been confirmed. Pirenzepine is an anticholinergic compound with a specific action on the muscarinic receptors of the parietal cells. Although pirenzepine appears effective in peptic ulcer, the results obtained in different centers have not been uniform. Sucralfate and tripotassium dicitrato bismuthate both act locally by coating the ulcer crater, the latter agent also liberating prostaglandins. Most prospective studies suggest that both drugs are effective when compared with placebo. Carbenoxolone heals 70% of gastric ulcers but is less effective against duodenal ulcers, and has a high incidence of side-effects. Treatment of peptic ulcer in the 1980s has been dominated by the advent of the H2-blockers, cimetidine and ranitidine. Peptic ulcer healing rates are similar with both drugs, and the main problem is how often and how much should be given in order to provide acceptable healing and to prevent ulcer recurrence. Other H2-blockers are being tested and they may be more effective either by healing more ulcers or healing them earlier. The clinical treatment of peptic ulcers will in future be advanced by the addition of two new classes of drugs, the prostaglandins and the benzimidazole derivatives, which are currently being investigated and appear extremely promising.
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The effect of bromopride (4-amino-5-bromo-N-(2-diethyl-aminoethyl)-2-methoxy-benzamide) on the pressure amplitude of the lower oesophageal sphincter was examined in ten healthy subjects and fifteen patients suffering from peptic oesophagitis. Diagnosis of peptic oesophagitis was based on the histological study of a sample of the lower oesophageal mucosa.
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