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Biomedical subjects

A Tittobello

Publications and source records attributed to A Tittobello.

At least 37 records · Page 2Linked to original sources
PubMed1993

Different interdigestive antroduodenal motility patterns in chronic antral gastritis with and without Helicobacter pylori infection.

Fasting antroduodenal motor activity was studied in 15 dyspeptic patients with chronic superficial antral gastritis and Helicobacter pylori infection (group A), 10 dyspeptic patients with chronic superficial antral gastritis without Helicobacter pylori infection (group B), and eight healthy control subjects (group C) by manometric recording of phases of the interdigestive migrating motor complex (MMC) prolonged over 240 min. A significantly lower incidence of activity fronts (phase III of MMC) starting from the antrum was observed in patients with gastritis and Helicobacter pylori infection vs patients without bacterial colonization (P = 0.013) and in these latter vs control subjects (P = 0.013). Likewise, the overall number of activity fronts was smaller in patients with gastritis than in healthy subjects (P = 0.034). Symptomatic evaluation was performed in the two groups of dyspeptic patients, without detecting any differences in frequency and severity of complaints. Our results show a significant reduction in the occurrence of interdigestive antral phase III of MMC in chronic gastritis associated with Helicobacter pylori infection, suggesting a possible relationship between fasting motility and bacterial colonization.

Adolescent↗
PubMed1993

Mucosal blood flow in erosive duodenitis.

Erosive duodenitis is a clinical entity whose pathogenesis is still obscure. Acid secretion is mostly normal, while the possible role of vascular factors has been suggested. We measured mucosal blood flow by means of laser Doppler velocimetry during endoscopy in the duodenal bulb of 10 subjects with erosive duodenitis, 10 duodenal ulcer patients, and 10 healthy controls. Duodenal blood flow in erosive duodenitis was significantly reduced (p < 0.001) compared with controls, whereas no changes were detected in duodenal ulcer. Reassessment of mucosal blood flow after a 6-week treatment with ranitidine failed to show any increase in the perfusion values even in patients with endoscopic healing. Our results suggest that impaired mucosal blood flow is a primary factor in the pathogenesis of chronic duodenal erosions.

Duodenal Ulcer↗
PubMed1993

Congestive gastropathy versus chronic gastritis: a comparison of some pathophysiological aspects.

In order to investigate some pathophysiological aspects of the two diseases, 15 patients with congestive gastropathy and 15 with chronic gastritis have been studied and compared with 15 healthy controls. Gastric blood flow as determined during endoscopy by means of laser Doppler flowmetry was found to be significantly increased (p < 0.001) in congestive gastropathy, whereas a significant reduction (p < 0.001) was noted in chronic gastritis. On the other hand, Helicobacter pylori was detected in 80% of cases in chronic gastritis, while the prevalence of the microorganism in congestive gastritis was similar to that in healthy controls. It is concluded that chronic gastritis and congestive gastropathy are related to different pathogenetic factors and require different therapeutic approaches.

Chronic Disease↗
PubMed1992

Breakdown of mucosal defences in congestive gastropathy in cirrhotics.

The gastric mucus-bicarbonate barrier, the first line of mucosal defence, has been evaluated in patients with congestive gastropathy and cirrhosis of the liver. Fourteen cirrhotic patients of both sexes (Child's class A or B), with or without oesophageal varices, but with endoscopic signs of congestive gastropathy, and a matched group of healthy controls were studied. The amount of luminal mucoproteins, a Mucoprotective Index as a qualitative assessment of mucus secretion and the output of gastric bicarbonate were determined in basal conditions. In patients with congestive gastropathy a significant (p < 0.01) reduction in all the above parameters was observed, suggesting a substantial impairment of the gastric mucus-bicarbonate barrier. Whether this is an independent phenomenon or a consequence of altered local microcirculation remains to be determined.

Aged↗
PubMed1992

Follow-up of endoscopic gastritis after healing with sucralfate or an H2-receptor antagonist.

48 patients in whom previous endoscopic signs of chronic gastritis had been abolished by treatment with either 1 g sucralfate three times daily or 40 mg famotidine at night were followed up for 3 months without further therapy. Cumulative endoscopic relapse rates at 3 months were 21.7% in the sucralfate group and 57.1% in the famotidine group (p = 0.017). All patients with endoscopic recurrence of gastritis also reported recurrence of dyspeptic symptoms of various degrees. Most patients with endoscopic relapse had persisting histologic gastritis, but up to 67% of subjects with histologic gastritis at the time of initial endoscopic healing did not have subsequent endoscopic or clinical recurrence. It is concluded that gastritis, especially if histologically active, tends to recur quickly after endoscopic healing and that early relapses are significantly more frequent after treatment with an H2 blocker than after sucralfate.

Famotidine↗
PubMed1992

Interdigestive antro-duodenal motor disorders in functional dyspepsia. Associated chronic gastritis correlates with a further motor impairment.

The interdigestive antro-duodenal motor activity was studied in 12 dyspeptic patients without gastritis (group A), 12 dyspeptic patients with chronic superficial antral gastritis (group B) and 8 healthy controls (group C) by manometric recording of phases of the interdigestive motility cycle (IDMC) prolonged over 240 minutes. A significantly lower incidence of migrating motor complexes (MMCs) starting from the antrum was observed in dyspeptic patients with gastritis vs dyspeptic patients without gastritis (p = 0.02) and in these latter vs controls (p < 0.01). Likewise, the overall number of MMCs was smaller in patients with gastritis vs controls (p = 0.02). Symptomatic evaluation was performed in the two groups of dyspeptic patients, without detecting any differences in frequency and severity of individual and overall complaints. Our results confirm the role of interdigestive antral motor abnormalities in the genesis of dyspeptic syndrome and suggest that the presence of associated chronic superficial gastritis may correlate with a further motor impairment.

Adolescent↗
PubMed1992

Omeprazole-induced changes in gastric mucus secretion.

The influence of omeprazole treatment on gastric mucus secretion in man was examined in two separate studies. 24 outpatients with endoscopic duodenitis but normal gastric mucosa were treated under double-blind conditions with either omeprazole 20 mg o.m. or placebo for four weeks. Omeprazole was found to induce a significant reduction (p less than 0.001) in the amount of neutral and total mucoproteins into the gastric juice and in the viscous and protective properties of mucus as assessed by a Mucoprotective Index. In a subsequent study 12 omeprazole-treated patients were re-examined either 10 days (6 patients) or 15 days (6 patients) after the drug withdrawal. A trend towards normalization of mucus secretion was detectable already after 10 days, but only at 15 days did gastric mucus fully revert to normal. The results suggest that the decrease in the quantity and quality of mucus secretion observed with omeprazole is a transient phenomenon, secondary to the sustained acid suppression induced by the drug and clinically irrelevant.

Adult↗
PubMed1991

Long-term efficacy of endoscopic papillo-sphincterotomy for common bile duct stones and benign papillary stenosis.

Since its introduction in 1974, endoscopic sphincterotomy (EST) for common bile duct stones and benign papillary stenosis has become a well-established therapeutic procedure; however, at present, its long-term efficacy in comparison with that of biliary tract surgery remains a matter of debate. The long-term results observed during our follow-up (4 +/- 2 years) were satisfactory, revealing the disappearance of or an improvement in symptoms in 85.6% of subjects who had undergone EST. Recurrent stones were documented in 10.2% of patients; EST-related stenosis occurred in 3.8% of cases, approximately 3 times more frequently in papillary stenosis than in choledocholithiasis, likely due to the presence of a more extended incision in cases with common duct stones. A gallbladder in situ did not seem to be an additional risk factor after EST. As documented in other recent follow-up studies, the long-term efficacy of EST seems to be confirmed and comparable with that of biliary surgery.

Adult↗
PubMed1990

Longterm oral cisapride improves interdigestive antroduodenal motility in dyspeptic patients.

We have evaluated the effect of cisapride on interdigestive antroduodenal motility during a prolonged oral therapy in 20 consecutive dyspeptic subjects. Individuals with less than two migrating motor complexes (MMCs) starting from the antral region in 240 minutes and without evidence of upper gastrointestinal tract diseases were randomly treated with either cisapride (10 cases), or placebo (10 cases) for 15 days. Computerised manometry of antroduodenal region was performed for 240 minutes, in basal conditions and on the 15th day of therapy. Symptomatic evaluation of patients was also performed before and after treatment. After cisapride administration, a significant increase in the incidence of antral migrating motor complexes was noticed (p = 0.022); likewise, the motility index, calculated for phase-2 periods, appeared to be significantly higher both in the antrum and in the duodenum (p less than 0.001). Symptomatic improvement was observed in both groups, with a hardly significant (p = 0.049) reduction of dyspeptic symptoms severity only but not of frequency in cisapride treated patients v controls. We conclude that longterm oral therapy with cisapride improves interdigestive antroduodenal motor activity.

Administration, Oral↗
PubMed1990

Weakening effect of famotidine but not of nizatidine on the mucus-bicarbonate barrier of the human stomach.

Twenty outpatients with various duodenal disorders but endoscopically normal gastric mucosa were randomly treated for 4 weeks with either nizatidine (300 mg h.s.) or famotidine (40 mg h.s.). Before and after treatment quantitative and qualitative evaluations of gastric mucus secretion as well as measurement of gastric bicarbonate output were performed. No changes in the mucus-bicarbonate barrier were observed after nizatidine treatment. In contrast, famotidine was found to impair the quality of mucus, thus weakening the mucosal defences against re-ulceration after treatment withdrawal.

Adult↗
PubMed1989

Effects of cimetropium bromide on gastrointestinal transit time in patients with irritable bowel syndrome.

Cimetropium bromide is a new antimuscarinic compound with strong antispasmodic activity. The aim of this study was to evaluate the effects of oral cimetropium bromide on total gut transit time in patients with irritable bowel syndrome. Forty patients, divided according to their initial total gastrointestinal transit times and presenting symptoms, were treated with cimetropium bromide 50 mg t.d.s. or placebo for 1 month according to a double-blind, parallel group design. Before and after treatment all subjects ingested 24 radio-opaque markers. The total intestinal transit time was determined by evaluating the rate of disappearance of markers from plain X-ray films of the abdomen taken every 24 h for 4 days. Pain and bowel habits were also monitored. Seven patients did not complete the study. Cimetropium bromide significantly (P less than 0.01) shortened the whole gut transit time in patients with prolonged transit time (80.8 +/- 4.0 h before vs 60.8 +/- 6.7 h after treatment) and improved the global clinical condition significantly compared with placebo (P = 0.029). In patients with a short total intestinal transit time, cimetropium bromide had no effect on whole gut transit time and did not significantly improve symptoms. The results of this study indicate that oral cimetropium bromide is effective both objectively and subjectively in a subgroup of irritable bowel syndrome patients with constipation.

Adult↗
PubMed1989

Manometric evaluation of the interdigestive antroduodenal motility in subjects with fasting bile reflux, with and without antral gastritis.

The interdigestive antroduodenal motor activity was studied in 15 patients with bile reflux without gastritis (group A), 17 with bile reflux and chronic antral superficial gastritis (group B) and in nine healthy controls (group C), by manometric recording of phases of the interdigestive motility complex (IDMC) over 240 minutes, or until two consecutive migrating motor complexes (MMCs) had been recorded, whichever the shorter. In the patients with bile reflux the occurrence of MMCs was decreased and median duration of the IDMC was significantly prolonged (group A = 162.5 min; group B = 185.0 min), compared with controls (group C = 92.0 min; p less than 0.01 v groups A and B). There were no differences in motility pattern between patients with and without gastritis, suggesting that motor abnormalities are not caused by gastritis, but may precede its occurrence. Delayed occurrence of motor activity fronts increases duodenogastric reflux, but correlation with gastric mucosal lesions was not shown, suggesting that other mechanisms are involved.

Adult↗