PubMed Health⌕ Search

Biomedical subjects

A Nowak

Publications and source records attributed to A Nowak.

At least 19 recordsLinked to original sources
PubMed1992

Penetration of tinidazole into skin blister fluid following its oral administration.

Plasma and skin blister fluid concentrations of tinidazole following a single oral dose of 2 g drug, and after multiple doses of 0.25 g every 12 h, were determined. Skin blisters were produced by direct application of 0.25% cantharidin ointment to the skin. The maximum concentration in plasma of about 36 mg.l-1 was observed after about 2 h, whereas in skin blister fluid the peak occurred after about 6 h and was 30 mg.l-1. The half-life in plasma was slightly shorter than in blister fluid at 17 and 19 h, respectively, but the difference was not significant. The penetration of tinidazole into cantharidin-induced skin blister fluid, defined according to Wise as the ratio of the AUCs in blister fluid and plasma was 1.00. During routine treatment with tinidazole (0.25 g every 12 h), the concentrations in plasma and blister fluid collected before and 3 h after the morning dose exceeded the minimal inhibitory concentrations for susceptible pathogens. The results provide a pharmacokinetic basis for the proven efficacy of tinidazole in the treatment of protozoal and anaerobic infections.

Administration, Oral↗
PubMed1992

[Manometric evaluation of the effects of intravenous administration of glucagon, buscopan and papaverine on the contractile activity of the sphincter of Oddi].

Endoscopic manometric technique was used to investigate the effects of spasmolytic drugs on the sphincter of Oddi (s.O.) motility. 41 patients were randomly divided into 4 groups. In every patient the characteristics of the s.O. was monitored before and during 5 min. period after i.v. administration of: 20 mg buscopan, 1 mg glucagon, 40 mg papaverine or 2 ml of 0.9% NaCl solution. After buscopan administration the amplitude and frequency of phasic contractions of the s.O. were decreased as well as a baseline pressure in the s.O. Glucagon reduced frequency and amplitude of phasic contractions of the s.O. without influencing the baseline pressure. Papaverine reduced only frequency of phasic contractions. Physiological saline caused no change in pressure characteristics of the s.O.

Adult↗
PubMed1991

Effect of nifedipine on interdigestive gallbladder volume and postprandial gallbladder emptying in man.

The effect of two oral doses (10 and 20 mg) of nifedipine versus placebo on the fasted gallbladder volume and on the meal-induced gallbladder emptying was assessed according to a double-blind study protocol in 12 healthy volunteers. Eight subjects underwent three studies (with placebo and with both nifedipine doses), whereas in two subjects the effect of a 10-mg nifedipine dose vs placebo and in two others the effect of a 20-mg nifedipine dose vs placebo was examined. The studies were performed on separate days, and the gallbladder volume was measured by means of real-time ultrasonography. Neither placebo nor 20 mg nifedipine per os elicited any significant change in the fasted gallbladder volume. With 10 mg nifedipine per os a significant increase in the interdigestive gallbladder volume was observed: 22.9 +/- 2.9 cm3 before and 26.2 +/- 3.2 cm3 after the drug receipt (P less than 0.005). A trend towards an inhibition of the postprandial gallbladder emptying was observed with 10 mg nifedipine per os without, however, reaching the level of statistical significance. Following 20 mg nifedipine per os, a marked delay in the meal-stimulated gallbladder emptying occurred, as reflected by a decrease in the gallbladder ejection fraction from 48.1 +/- 4.5% (placebo) to 26.4 +/- 5.0% (nifedipine) (P less than 0.02) at 30 min and from 54.0 +/- 3.6% (placebo) to 33.2 +/- 4.6% (nifedipine) (P less than 0.02) at 40 min after the test meal. We conclude that a therapeutic oral dosage of nifedipine has a significant relaxing effect on the human gallbladder.

Adult↗
PubMed1991

[Endoscopic prosthesis of the biliary tract].

In the years 1987--1989 endoscopic biliary tree stenting was performed in 64 patients. The straight prostheses type Amsterdam 10 or 12 F and double pigtail prostheses were applied. In 36 cases the indication for stenting was malignant stricture of the biliary tree (group I) caused by carcinoma of the ampulla of Vater (n = 12), carcinoma of the head of the pancreas (n = 15), common bile duct and bifurcation tumor (n = 5) and gallbladder cancer (n = 4). In 28 cases the indications were common bile duct stones (group II) where stone size made endoscopic removal impossible and surgery was contraindicated. Normalisation or improvement of elevated serum bilirubin level was observed quite quickly after stenting (it decreased to about 50% of initial value after 7 days). Mean duration of prosthesis patency in group I patients who avoided surgical treatment was 144 days and mean survival time was 220 days. In group II patients mean duration of prosthesis patency was 183 days. Endoscopic biliary tree stenting is an advantageous alternative to surgical palliative++ treatment of obstructive neoplastic jaundice and constitutes an efficient method of treating common bile duct stones in poor operative risk patients.

Adult↗
PubMed1991

[Emergency endoscopic sphincterotomy in acute obstructive cholangitis].

In 45 patients with acute obstructive cholangitis (AOC) endoscopic sphincterotomy (ES) was performed within 24 hours after admission. Criteria for the diagnosis of AOC were as follows: clinical symptoms consisting of fever and chills, right upper abdominal pain, and jaundice (Charcot's triad) with coexisting laboratory data as elevated WBC, ERS, bilirubin level and evidence of obstructive biliary disease confirmed by endoscopic retrograde cholangiopancreatography. The causes of AOC were: in 38 patients (84.5%)--common bile duct stones, in 2 patients (4.5%)--carcinoma of the papilla of Vater, and in 5 patients (11%)--benign stenosis of the papilla of Vater. A rapid clinical improvement was observed in 40 patients after ES. Within 24 hours after ES patients had relief of pain, fever subsided and white blood cell count returned from 11.7 +/- 6.9 G/l to 7.0 +/- 3.0 G/l. Bilirubin level decreased from 101 +/- 86 mumol/l to 77 +/- 68 mumol/l. Endoscopic drainage failed only in 4 patients (9%) who required surgery. One patient (2%)--died. In the treatment of acute obstructive cholangitis urgent endoscopic sphincterotomy should be a method of choice. Surgery should be reserved only for patients in whom ES failed.

Acute Disease↗
PubMed1991

Inhibitory effect of cigarette smoking on gastric emptying of a solid meal in patients with type I gastric ulcer.

The effect of cigarette smoking on gastric emptying (GE) of a radio-labelled solid meal was examined in 14 patients with type I gastric ulcer diagnosed at endoscopy. The patients underwent GE measurement thrice: under basal conditions and for two smoking sessions--without and after cimetidine pretreatment (2 x 400 mg orally for 2 days and 400 mg orally 1.5 h before the isotopic GE examination). Cigarette smoking significantly delayed GE--the median GE index, Ix: 0.688 min-1.10-2 (range 0.033-1.886) after smoking vs. 1.246 min-1.-2 (range 0.384-2.339) under basal conditions, p less than 0.01. The inhibitory effect of smoking on solid GE was blunted when smoking coincided with cimetidine pretreatment--the median Ix amounted to 1.069 min-1.10-2 (range 0.022-1.462) and was not significantly different from that under basal conditions.

Adult↗
PubMed1991

Factor XIII subunits in relation to some other hemostatic parameters in ulcerative colitis.

The hemostatic parameters, particularly with respect to F.XIII subunits, were examined in 48 untreated UC patients (22 at active and 26 at quiescent stage). UC active patients showed a significant decrease of F.XIII subunit "a," compared with healthy subjects, as well as in UC patients in remission. In contrast, the level of F.XIII subunit "b" in each group was similar. Compared with normal subjects, UC active patients revealed a significant decrease in AT III concentration, prolonged ELT, and elevated fibrinogen level. In addition, the elevated titer of SDPS test for SFMC appeared in approximately 40% of those patients. However, no strict relationship was found between the presence of positive SDPS and diminution of AT III, as well as of F.XIIII subunit "a" in active UC state. In patients in remission, AT III level and ELT were similar to those as in the control group, but fibrinogen concentration was elevated. Such constellation of hemostatic parameters may indicate a tendency to blood hypercoagulability in UC active patients, whereas, in general, these changes are not associated with the stage of remission. The present data may also suggest that F.XIII behavior pattern should be taken into account in the clinical management of UC.

Adolescent↗
PubMed1990

Two-stage penetration of a single oral dose of sulphadimethoxine into skin blister fluid.

The time-dependent concentration curves of sulphadimethoxine in plasma and cantharidin-induced skin blister fluid have been evaluated following a single oral dose of 1 g. In contrast to other drugs, sulphadimethoxine exhibited two-stage penetration into the blister fluid, the second peak concentration being higher than the first. The maximum plasma concentration of 94.1 mg.l-1 was observed after 4 h, and in skin blister fluid the first peak of 25.6 mg.l-1 was found after 7 h, and the second of 58.0 mg.l-1 occurred after 30 h. The penetration of sulphadimethoxine into skin blister fluid, defined as the ratio of the AUC there to that in plasma was 0.748. The results suggest that sulphadimethoxine penetrates into skin blister fluid to a great extent from plasma and achieves concentrations exceeding the MIC for susceptible pathogens, but it requires a relatively long time to do so.

Administration, Oral↗
PubMed1990

Patency of the Santorini duct and acute biliary pancreatitis. A prospective ERCP study.

Disturbance of outflow of the pancreatic juice is considered to be a pathogenic factor in the development of acute biliary pancreatitis (ABP). In the years 1984-1988 sixty-seven patients admitted with ABP were prospectively allocated to urgent ERCP and endoscopic sphincterotomy. Diagnostic criteria of acute biliary pancreatitis were as follows: epigastric pain, an elevated serum amylase concentration, biochemical prediction of gallstones, positive pattern of pancreatitis in US and CT-scan and ERCP performed within 24 h of admission. At ERCP the anatomy of the pancreatic duct was evaluated and special attention was paid to the patency of the accessory (Santorini) duct as a potential outflow route of the pancreatic juice. The control group comprised 100 consecutive patients in whom a pancreatogram was obtained during ERCP performed because of expected biliary pathology. Patency of the Santorini duct was found merely in 17% patients with ABP. In contrast, this duct was patent in 69% of the patients in the control group (p less than 0.001). The absence of this additional possibility of draining pancreatic juice might be an important pathogenic factor in acute biliary pancreatitis.

Acute Disease↗
PubMed1990

A synthetic prostaglandin E2 analogue, enprostil, hastens gastric emptying of solids in patients with an active duodenal ulcer.

The effect of gastric emptying of two doses (35 and 70 micrograms) of enprostil given orally was evaluated in eight patients with endoscopically confirmed duodenal ulcer. Gastric emptying of a radiolabelled solid meal was assessed with the use of a gamma camera. Enprostil dose-dependently accelerated gastric emptying of solids; the gastric emptying index, Ix, increased from 1.62 +/- 0.38 min-1.10(-2) after placebo to 2.77 +/- 0.56 min-1.10(-2) after 35 micrograms enprostil (p less than 0.05 versus placebo) and to 3.65 +/- 0.64 min-1.10(-2) after 70 micrograms enprostil (p less than 0.005 versus placebo). The fraction of the radiolabelled food retained in the stomach at the end of the gastric emptying examination (that is, after 90 min) amounted to 50.5 +/- 6.9% after placebo, 35.2 +/- 7.4% after 35 micrograms enprostil, and 24.1 +/- 8.4% after 70 micrograms enprostil. It is concluded that enprostil elicits a significant speeding up of solid-phase gastric emptying in duodenal ulcer patients.

Administration, Oral↗
PubMed1990

[Fibrosing cholangiolitis after administration of methyltestosterone].

A case of intrahepatic cholestasis of great intensity was observed in a patient taking methyltestosterone. In histological examination of liver biopsy specimen evidence was found of fibrosing intralobular cholangiolitis. The histological findings and the clinical course are discussed considering the disease as an atypical liver reaction to methyltestosterone.

Bile Ducts, Intrahepatic↗
PubMed1990

[Effect of smoking on caffeine elimination by the liver in patients with chronic liver diseases].

Effect of smoking cigarettes on hepatic metabolizing capacity of caffeine in respect to the extent of liver damage was studied among 46 patients with chronic liver disease and 6 healthy, nonsmoking subjects. The rates of hepatic elimination in cirrhosis (68 +/- 35 ml/min) and chronic extrahepatic cholestasis (60 +/- 32 ml/min) were lower in comparison to steatosis (132 +/- 38 ml/min), chronic active hepatitis (115 +/- 35 ml/min) and healthy control group (115 +/- 46 ml/min). Generally, the patients smoking cigarettes (n = 21) metabolized caffeine more rapidly than nonsmoking patients (107 +/- 42 ml/min vs 71 +/- 41 ml/min, p less than 0.01). In cirrhotics we observed the 9% difference of caffeine clearance between smokers and non-smokers, whereas in ++ groups of patients showing no significant impairment of caffeine elimination rate (steatosis, hepatitis) the tobacco induced the 33% change in caffeine clearance. Healthy nonsmoking subjects metabolized caffeine more rapidly than smoking cirrhotics (115 +/- 46 ml/min vs 71 +/- 26 ml/min, p less than 0.05). It may be concluded that smoking cigarettes increase hepatic elimination rate of caffeine in chronic liver disease, however the range of this effect depends upon the extent of liver damage.

Adolescent↗
PubMed1990

[Effect of acute biliary pancreatitis on liver metabolism of phenazone].

In 22 patients with acute pancreatitis caused by biliary calculi and 9 healthy controls the rate of hepatic elimination of phenazone was measured. The aim of the study was evaluation of the oxidative-detoxicating action of the liver in this disease in relation to its severity. In pancreatitis patients the half-time (T2) of phenazone was significantly (p less than 0.01 longer than in healthy subjects (23.6 +/- 10.5 vs 13.2 +/- 7.2 hrs). The T2 of phenazone was not correlated with the concentrations of transaminases, bilirubin and prothrombin, but was correlated positively with the concentration of hepatic lactic dehydrogenase (p less than 0.001). In the initial stage of pancreatitis the T2 of phenazone was without prognostic significance and showed no agreement with Ranson's clinical-laboratory classification of the severity of the disease. The degree of impairment of the hepatic metabolism of phenazone measured with the percent difference between T2 of phenazone in both tests was significantly (p less than 0.05) greater in the group of patients with complications than in those without pancreatitis complications (70.7 +/- 64.4% vs 21.4 +/- 16.2%). Biliary pancreatitis impairs the oxidative-reductive function of the liver proportionally to the degree of hepatic lactic dehydrogenase in the serum. Evaluation of the rate of hepatic elimination of phenazone in the initial stage of this pancreatitis was without prognostic importance for the severity of the disease.

Acute Disease↗