PubMed Health⌕ Search

Biomedical subjects

M Traube

Publications and source records attributed to M Traube.

43 records · Page 3Linked to original sources
PubMed1984

Effects of nifedipine on esophageal motor function in humans: correlation with plasma nifedipine concentration.

We studied the effects of the calcium-channel blocker nifedipine on esophageal smooth muscle function in 10 normal volunteers. Lower esophageal sphincter pressure and relaxation and esophageal contraction amplitude, peristalsis, velocity, and duration after wet swallows were determined before and for 120 min after the sublingual/buccal administration of placebo and of nifedipine in doses of 10, 20, 30, and 40 mg. Blood samples for measurement of plasma nifedipine concentration were obtained at baseline and every 30 min during this 120-min period. Nifedipine led to decreases in sphincter pressure of 13.3%, 29.9%, 34.3%, and 35.1% as the dose was increased from 10 mg to 40 mg. These changes were significantly (p less than 0.05) different from baseline and placebo for the 20-, 30-, and 40-mg doses and were more sustained with the higher doses, lasting as long as 90 min. Contraction amplitude fell 5.3%, 5.9%, 13.5%, and 19.6% at the corresponding doses. These changes were significantly (p less than 0.05) different from baseline and placebo only for the 30- and 40-mg doses, with the effect lasting up to 60 min. Peak plasma nifedipine concentration ranged from 28.7 +/- 3.7 ng/ml (mean +/- SEM) after 10 mg to 138.7 +/- 43.7 ng/ml after 40 mg of the drug, and occurred at either the 30- or 60-min measurement. The mean percent of decrease in sphincter pressure and contraction amplitude in the esophageal body correlated (p less than 0.001) with plasma nifedipine levels. There were no changes in sphincter relaxation or in peristalsis, velocity, or duration of contraction with any dose of nifedipine. It is concluded that (a) nifedipine significantly decreases lower esophageal sphincter pressure and contraction amplitude in the body of the esophagus, (b) the effect on sphincter pressure requires a lower dose of nifedipine and is more marked than that on contraction amplitude, and (c) the effects on both sphincter pressure and contraction amplitude correlate with plasma nifedipine levels. Calcium-channel blockers such as nifedipine may have a role in the treatment of motility disorders of the lower esophageal sphincter or esophageal body, and further controlled clinical studies are indicated.

Adult↗
PubMed1983

High-amplitude peristaltic esophageal contractions associated with chest pain.

Review of esophageal motility tracings performed during a three-year period yielded 112 patients who underwent the test because of chest pain of unclear etiology. Thirteen patients had high-amplitude peristaltic contractions. All 13 patients had pressurelike pain, ten had dysphagia, and six had symptoms of gastroesophageal reflux. The presence of an elevated lower esophageal sphincter pressure in five patients suggested a spectrum of hypertensive disorders of the esophagus variously affecting the body, the sphincter, or both. This latter subgroup responded to esophageal bougienage. Six patients had objective evidence for gastroesophageal reflux. These patients had at least partial relief from antireflux measures. High-amplitude peristaltic contractions should be considered in the differential diagnosis of noncardiac chest pain, since recognition of this entity can lead to appropriate management and symptom relief.

Adult↗
PubMed1983

D-Lactic acidosis after jejunoileal bypass: identification of organic anions by nuclear magnetic resonance spectroscopy.

A 40-year-old man with jejunoileal bypass developed a syndrome of bizarre behavior, slurred speech, ataxic gait, and inappropriate affect, associated with a metabolic acidosis characterized by an increase in the anion gap. Serum L-lactate level was normal, but high-resolution proton nuclear magnetic resonance spectrums of the patient's serum showed a high concentration of lactate. A diagnosis of D-lactic acidosis was confirmed by a specific enzymatic assay for D-lactate. The D-lactic acidosis was cleared using antibiotic therapy, suggesting that D-lactate is produced from fermentation of ingested carbohydrate by colonic bacteria. Nuclear magnetic resonance spectroscopy is a rapid screening test for identifying organic acids in patients with unexplained acidosis. Neuropsychiatric symptoms in patients with short bowel syndrome may be associated with D-lactic acidosis.

Acid-Base Equilibrium↗
PubMed1981

Meckel's diverticulum. An unusual case with ileal stricture.

A 31 year-old man was seen with acute gastrointestinal bleeding. Superior mesenteric angiography revealed a vascular blush. This corresponded to an area of narrowing seen on the small bowel series. A diagnosis of malignant neoplasm was made preoperatively. At laparatomy, however, a Meckel's diverticulum with ulceration and stricture formation extending into the ileum was found. The histology showed gastric mucosa with ulceration. This report depicts small bowel narrowing secondary to Meckel's diverticulum.

Adult↗