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Biomedical subjects

D Nompleggi

Publications and source records attributed to D Nompleggi.

11 recordsLinked to original sources
PubMed2001

Interventional endoscopy.

Interventional endoscopy is a general label given to endoscopic procedures used to deal with a variety of gastrointestinal disorders. The interventional endoscopic procedures of interest in this review are those used specifically with gastric disorders. They include hemostasis, endoscopic ultrasound, endoscopic mucosal resection, stenting, percutaneous endoscopic gastrostomy tube placement and photodynamic laser therapy. Here, we review the latest data related to (a) a number of general issues having an impact on this diverse group of procedures (eg, such as proper patient selection criteria, consent in the era of open access endoscopy, protocol for anticoagulation, and sedation); (b) the methodology and outcomes of each of these unique procedures as they apply to the stomach; and (c) some of the latest technologic advances and developments that will potentially have an impact the future use of these procedures.

Journal Article↗
PubMed1997

Dietary cow's milk protein does not alter the frequency of diabetes in the BB rat.

One theory of the pathogenesis of IDDM proposes that exposure to cow's milk proteins triggers the disease in genetically susceptible individuals. We tested this hypothesis in the BB/Wor rat model of human IDDM. Diabetes-prone (DP) BB/Wor rats spontaneously develop IDDM. Coisogenic diabetes-resistant (DR) BB/Wor rats do not develop diabetes spontaneously, but IDDM can readily be induced by treatment with polyinosinic:polycytidylic acid and depletion of RT6+ T-cells. Pregnant BB/Wor rats were fed one of four experimental diets or a standard Purina commercial rat chow (5010) that was certified to be free of cow's milk protein. Offspring were maintained on the maternal diet after weaning. DP-BB/Wor rats, fed either of two experimental diets based on hydrolyzed casein and free of intact milk protein (Nutramigen or D11236), developed diabetes at only half the rate of animals fed Purina 5010 chow. Neither the addition of bovine serum albumin (BSA) to Nutramigen nor the substitution of total milk protein for the hydrolyzed casein in the D11236 diet increased the frequency of spontaneous diabetes. In contrast, there was no relationship between diet and susceptibility of DR-BB/Wor rats to IDDM induction. However, the methods used to induce IDDM in DR-BB/Wor animals were found to induce antibodies against BSA. We conclude the following: 1) Dietary modification can reduce spontaneous IDDM expression in DP-BB/Wor rats, but the agent of protection is not elimination of cow's milk protein. 2) The addition of BSA or intact milk protein does not abrogate the effectiveness of a protective diet. 3) The genetic susceptibility of the DR-BB/Wor rat to autoimmune diabetes is unaffected by any of the tested diets, but a role of anti-BSA-like autoreactivity in IDDM expression cannot be excluded.

Animals↗
PubMed1988

Histamine H2 receptor stimulation increases gastric emptying in monkeys.

We studied the effect of the specific H2 receptor agonist dimaprit on gastric emptying using a dye dilution technique in five chair-adapted rhesus monkeys to determine simultaneously gastric emptying and H+ secretion. Continuous subcutaneous injections of either saline alone or dimaprit (15, 30, 60, 120, and 240 nmol.kg-1.min-1) were given in random order on separate days. Both fractional emptying rate and H+ output were significantly increased by higher doses of dimaprit, with resulting twofold concurrent increase of intragastric H+ concentration. Because intragastric administration of H+ decreases gastric emptying and secretion, we evaluated the possibility that the stimulatory action of a histamine H2 agonist was underestimated when gastric pH was greater during control than after dimaprit. When exogenous HCl was added to the stomach to achieve H+ concentrations similar to those measured after dimaprit, both fractional emptying and H+ secretion were decreased twofold. When these "acidified control values" were used as a point of comparison, the stimulatory effect of dimaprit on both fractional emptying and gastric secretion was greater, suggesting that the stimulatory actions of dimaprit are underestimated if one does not take into account the differences in intragastric H+ concentrations.

Animals↗
PubMed1982

A prostaglandin endoperoxide analog increases gastric emptying and suppresses gastric secretion in rhesus monkeys.

The effects of a stable endoperoxide analog, U-46619, were studied in five conscious chair-adapted rhesus monkeys. A dye dilution technique was used to determine simultaneously gastric fractional emptying, fluid output and ion output. A continuous infusion of either saline or U-46619 (0.2 micrograms/kg/min i.v.; 1 or 2 micrograms/kg/min s.c.) was given during a basal period and after distension of the stomach with an 80-ml water load. These studies demonstrate that U-46619 increases basal, but not postload fractinal emptying, and inhibits parietal secretion. These actions are similar to some of the effects of prostacyclin, prostaglandin E2 and prostaglandin F2 alpha on gastric emptying and secretion.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1981

Effect of a prostaglandin F2 alpha analog on gastric emptying and secretion in rhesus monkeys.

The effects of 15(S)-15 methyl prostaglandin (PG) F2 alpha (mePGF2 alpha) on gastric emptying and secretion were studied in five conscious chair-adapted rhesus monkeys. A dye dilution technique was used to determine simultaneously fractional emptying rate, hydrogen ion (H+) output, fluid output and H+ concentration of the gastric juice. A continuous s.c. infusion of either saline or mePGF2 alpha (1 or 2 micrograms/kg/min) was given during a 40-min basal period and after intragastric administration of an 80-ml water load. The PGF2 alpha analog significantly inhibited both basal and postload H+ output but did not alter fluid output. As a result, the basal and postload H+ concentration of the gastric juice was significantly decreased. In addition to its antisecretory effect, mePGF2 alpha significantly enhanced postload gastric fractional emptying.

Animals↗
PubMedDate not supplied

Overview of gastrointestinal disorders due to diabetes mellitus: emphasis on nutritional support.

Gastrointestinal disorders associated with diabetes mellitus have a prevalence rate of 30 to 75%. The most prominent disorders are gastroparesis, diarrhea, and constipation. Severity of symptoms range from mild to severe with the most affected patients being at risk for the development of protein calorie malnutrition. An historical review of the major studies which defined the diagnosis, pathophysiology, and prevalence of these disorders is presented. Guidelines for accurate nutritional assessment, which is essential to the decision to initiate nutritional therapy in this difficult to assess population, are also included. Current methods devised for treatment of diabetic gastroparesis and related disorders are presented. Emphasis is placed on recent developments in nutritional support techniques which make it possible to meet the energy requirements of all such patients. Practical outlines for glucose control in patients receiving TPN or enteral feeding and guidelines for transitioning from parenteral feeding to an oral diet are also presented.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Continuous v intermittent cimetidine infusion in critically ill hospitalized patients: role of TPN admixture as drug vehicle.

Previous studies suggest that continuous or intermittent cimetidine infusion provides a stable and sustained therapeutic blood concentration that maintains a gastric pH greater than 4.0. Twenty-seven patients receiving cimetidine were randomized to one of five treatments. Groups 1 and 2 were given cimetidine intermittently, whereas Groups 3, 4, and 5 received the drug continuously via a total parenteral nutrient (TPN) admixture. Group 1 was given 300 mg every 8 hours, and Group 2 received 300 mg every six hours. Groups 3, 4, and 5 received 600, 900, and 1200 mg per day, respectively, as a continuous infusion in the TPN admixture. Forty-eight individually prescribed TPN admixtures were used to deliver cimetidine continuously; 23 were composed of amino acids and glucose as base nutrients, whereas 25 contained amino acids, glucose, and lipids (3-in-1 or total nutrient admixtures). Serum levels of cimetidine were measured six times in 40 h (Group 1) or 42 h (Group 2-5). A two-way analysis of variance (ANOVA) revealed statistically significant differences in the serum cimetidine concentrations between groups (p less than 0.0001), but not with respect to time interval (p = 0.8687). No significant differences were noted in mean serum cimetidine concentrations between Groups 2 and 3, despite employing half the total dose in Group 3. Equivalent daily dosages were then stratified as the percentage of subtherapeutic (less than 500 ng/ml), therapeutic (500-1250 ng/ml), and supratherapeutic (greater than 1250 ng/ml) values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗