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At least 199 records · Page 11Linked to original sources

PubMed1994

Nutritional management of gastrointestinal tract diseases of dogs and cats.

Pharmaceutical agents are often given inappropriate precedence in the treatment of gastrointestinal tract diseases. Nutrients have marked influences on the gastrointestinal tract and manipulation of the diet provides clinicians with a powerful therapeutic strategy to be used alone or concurrently with drug therapy. During acute gastroenteritis a change from the animal's regular food to a diet containing novel protein sources minimizes the likelihood of acquired food allergies to the staple protein components of the diet. "Feeding through" diarrhea, a method used in human infants, has limited applicability in dogs and cats. The ideal diet for chronic small bowel-type diarrhea is highly digestible, gluten-free, hypoallergenic, isosmolar, low in fat and low in lactose. Dietary protein requirements increase in protein-losing enteropathy. Dietary fat is kept to a minimum during gastrointestinal dysfunction because malabsorbed fatty acids and bile acids cause secretory diarrhea. In diseases of the small bowel, it is traditional to use low fiber diets. This recommendation needs revision because the binding and gelling properties of fiber are of potential benefit in the treatment of small bowel diarrhea. High fiber diets are useful in most large bowel diseases. The specific fiber type used markedly influences the clinical result.

Animal Feed↗

PubMed2001

Mitochondrial enteropathy: the primary pathology may not be within the gastrointestinal tract.

BACKGROUND: Mitochondrial DNA (mtDNA) defects are an important cause of disease. Although gastrointestinal symptoms are common in these patients, their pathogenesis remains uncertain. AIM: To investigate the role of the mtDNA defect in the production of gastrointestinal dysfunction. PATIENT: A 20 year old woman who presented at 15 years of age with recurrent vomiting and pseudo-obstruction, who did not respond to conservative management and ultimately had subtotal gastrectomy and Roux-en-y reconstruction. She subsequently presented with status epilepticus and was found to have a mitochondrial respiratory chain disorder due to a pathogenic mtDNA point mutation (A3243G). METHODS: Resected bowel was studied using light and electron microscopy and mtDNA analysed from both mucosal and muscular layers using polymerase chain reaction generated RFLP analysis. RESULTS: Histological and electron microscopic studies revealed no morphological abnormalities in the resected stomach, and molecular genetic analysis failed to identify the genetic defect in either the mucosal or muscle layers. CONCLUSION: This study suggests that in some individuals with gastrointestinal symptoms associated with established mitochondrial DNA disease, the primary pathology of the mitochondrial enteropathy lies outside the gastrointestinal tract.

Adolescent↗

PubMed2004

[Serum cortisol levels in pre and post journal labor and non auditory manifestations in noise exposed workers of a brewer industry].

The purpose of this work was to determine the effects of environmental noise in the serum cortisol levels pre and post journal labor and the presence of non-auditory manifestations in workers of a brewer industry. A transversal study was carried out selecting at random 40 workers exposed to noise from the packing area, with ages between 20 and 55 years; and 40 workers from the administrative area without occupational exposition. The exposition was established by means of a medical-occupational history. A 5 mL whole blood sample was taken from each worker pre and post labor day to measure the serum cortisol for electrochemoluminescence. The level of industrial noise was evaluated with a model Quest 1700 sonometer. In the exposed group, there was a higher post labor day serum cortisol concentration than in the control group (p < 0.05). The non auditory manifestations registered were: migraine (50%), gastrointestinal dysfunctions (10%), hypertension (17.75%), irritability (27.5%), insomnia (55%); in spite of the use of auditory protectors in 92.5% of the workers. The levels of noise were > 85 dBA in all the workstations studied. There was not a significant relationship between the intensity of the noise in the workstations and the levels of serum cortisol.

Adult↗

PubMedDate not supplied

[Specific IgA against multiple antigens as expression of immunologic deregulation in HIV-positive children].

B-cell dysfunction in HIV-infected children is reflected by hypergammaglobulinemia and high levels of serum IgA. Little is known about antibody specificity since only a small portion of serum IgA appears to be directed against HIV proteins. In the present study the specificity of IgA antibodies against food, inhalant, bacterial and fungi antigens were evaluated in a population of HIV infected children. ELISA method was used for antibody testing. Our results show that in 84.6% of patients IgA against at least one food antigen are present. IgA against inhalant allergens were present in most of HIV-infected children but in none of controls. As for anti-tetanus toxoid antigens and anti-fungi antigens, though present in higher percentage in patients, specific IgA were found also in healthy children. If a gastrointestinal dysfunction might be supposed as the cause of presence of anti-food antigen IgA, it is difficult to consider this factor as the cause of presence of specific IgA directed against different antigens. It is possible to postulate that an immunologic dysregulation based on an imbalance between Th1 and Th2 cells or on higher levels of IL-5 and/or IL-6 may lead to a misfunction of B cell and consequently to hypergammaglobulinemia with high IgA levels.

Antibody Specificity↗

PubMed2003

The spectrum of autoimmune autonomic neuropathies.

We analyzed the clinical characteristics of 18 patients (13 female, 5 male) who had autoimmune autonomic neuropathy (AAN) and ganglionic acetylcholine receptor (AChR) autoantibodies. Mean age was 61.4 years (standard deviation, 12.0 years). Ten patients had subacute symptom onset, six with an antecedent event. Eight patients had chronic AAN, characterized by insidious symptom onset, without antecedent event, and gradual progression. A majority of patients with high antibody values (>1.00 nmol/L) had a combination of sicca complex (marked dry eyes and dry mouth), abnormal pupillary light response, upper gastrointestinal symptoms, and neurogenic bladder. Chronic AAN segregated into two subgroups. One subgroup (N = 4) had low antibody titer (0.09 +/- 0.01 nmol/L) and a paucity of cholinergic symptoms. It was indistinguishable from pure autonomic failure. The other subgroup (N = 4) had high antibody titer (11.6 +/- 2.08 nmol/L), sicca complex, abnormal pupils, and neurogenic bladder; three had severe upper gastrointestinal dysfunction. Higher antibody titers correlated with greater autonomic dysfunction and more frequent cholinergic dysautonomia. These observations expand the clinical spectrum of AAN to include chronic cases, some being indistinguishable from pure autonomic failure, and support the concept that ganglionic AChR antibodies are important diagnostically and pathophysiologically in acquired dysautonomia.

Adolescent↗

PubMed1993

Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy (PEG) is the preferred method for administration of long-term enteral tube feeding. However, most published studies describe only short-term follow-up in any detail. We report the long-term outcome and complication rate after PEG insertion in 49 patients (mean [SE] age 64 [2] years) whose mean length of PEG feeding was 175 days (range 30-560). Data were collected prospectively. PEG insertion was technically successful in all cases, with a procedure-related mortality of 2%. Early (< 30 days) mortality and morbidity were 8% and 22%, respectively. Of 45 patients surviving for more than 30 days, 76% were able to return home and 6 patients were eventually able to revert to oral feeding. There were 27 late complications: 2 site infections, 17 mechanical problems, and 8 episodes of gastrointestinal dysfunction. 51% of patients had no problems at all and 22% had 2 or more complications. 47% of complications required a hospital visit for resolution. Long-term enteral feeding by PEG was safe, effective, and had a low complication rate. Our patients were managed by a specialist nutrition team, a policy that may reduce the complication rate and hospital visits for patients being fed at home, and allow early discharge of dysphagic patients, thereby reducing costs.

Aged↗

PubMedDate not supplied

Autonomic nervous system dysfunction involving the gastrointestinal and the urinary tracts in primary Sjögren's syndrome.

OBJECTIVE: Antibodies reacting with the m3 subtype muscarinic acetylcholine receptor appear to be an important pathogenic factor in primary Sjögren's syndrome (pSS). As this receptor subtype is functionally important in the gastrointestinal and urinary tracts, and very little is known about the autonomic nervous system function in these organs in pSS patients, the occurrence and clinical significance of an autonomic nervous system dysfunction involving the gastrointestinal and urinary tracts were investigated. METHODS: Data on clinical symptoms attributable to an autonomic dysfunction were collected from 51 pSS patients. Gastric emptying scintigraphy and urodynamic studies were performed on 30 and 16 patients, respectively, and the results were correlated with patient characteristics and with the presence of autonomic nervous system symptoms. RESULTS: Gastric emptying was abnormally slow in 21 of the 30 examined patients (70%). Urodynamic findings, compatible with a decreased detrusor muscle tone or contractility were found in 9 of the 16 patients tested (56%). Various symptoms of an autonomic nervous system dysfunction were reported by 2-16% of the patients. CONCLUSION: Signs of an autonomic nervous system dysfunction involving the gastrointestinal and the urinary systems can be observed in the majority of pSS patients. This high occurrence is rarely associated with clinically significant symptoms. The authors presume a role of autoantibodies reacting with the m3 muscarinic acetylcholine receptor in the elicitation of the autonomic dysfunction.

Adult↗

PubMed2000

Enhancement of bowel sounds by wavelet-based filtering.

This paper evaluates the performance of an automatic method for structural decomposition, noise removal and enhancement of bowel sounds (BS), based on the wavelet transform. The proposed method combines multiresolution analysis with hard thresholding to compose a wavelet transform-based stationary-nonstationary (WTST-NST) filter, for enhanced separation of bowel sounds (BS) from superimposed noise. Quantitative and qualitative analysis of the experimental results, when applying the WTST-NST filter to BS recorded from controls and patients with gastrointestinal dysfunction, prove that the ability of the WTST-NST filter to remove noise and reveal the authentic structure of BS is excellent. By eliminating the need to record a noise reference signal, this method reduces hardware overhead when analysis of BS is the primary aim. The method is independent of subjective human judgement for selection of noise reference templates, is robust to different levels of signal interference, and, due to its simplicity, can easily be used in clinical medicine.

Adult↗

PubMed2003

A phase I and pharmacodynamic study of sequential topotecan and etoposide in patients with relapsed or refractory acute myelogenous and lymphoblastic leukemia.

We designed a pharmacokinetic and pharmacodynamic phase I study of sequential topotecan (2.55-6.3mg/m2) by 72h infusion followed by five daily doses of etoposide for patients with refractory acute leukemia based upon synergistic anti-tumor activity of topoisomerase I and II inhibitors in vitro. Eight of the 29 patients achieved bone marrow aplasia and two patients achieved clinical remission. Common grade 3-4 toxicities included hepatic and gastrointestinal dysfunction, and correlated with increased steady-state plasma topotecan concentration. The predicted up-regulation of topoisomerase II activity by topoisomerase I inhibition was not observed at this dose and schedule and may provide insight into the modest anti-leukemia activity of the regimen.

Acute Disease↗

PubMedDate not supplied

The dyspeptic syndrome in migraine: morphofunctional evaluation on 53 patients.

The authors, in order to evaluate the important role of gastrointestinal dysfunction during the migraine attack, have studied 53 patients with migraine without aura during the asymptomatic stage between attacks. Patients were examined functionally with a pH meter test of the gastroesophageal tract over 24 hours and morphologically with esophagogastroduodenoscopy. The results of this study point out that in a high percentage of patients with migraine, both evaluations are normal. The authors suggest the possibility of detecting, even hypothetically, an alteration of the common neurotransmitter substrate in the origin of migraine attacks and accompanying symptoms.

Adult↗

PubMed1987

[A case of acute sensory and autonomic neuropathy with regression].

The authors report the case of a 24 year old man with no previous disease who presented with a severe autonomic neuropathy. This included major gastrointestinal dysfunction characterised by decreased peristalsis without distension and paralysis of the gall bladder, and orthostatic hypotension with a normal cardiac tachycardia reflex. There was an associated sensory neuropathy affecting heat sensitivity without motor dysfunction and an increased CSF protein content. The proprioceptive nerve fibre conduction was decreased but another nerve conduction was normal initially. The mesenteric plexuses examined during sigmoidectomy performed for peritonitis due to multiple bowel perforations caused by fecoliths, showed no significant changes. Peripheral nerve biopsy revealed massive rarefaction of myelinated fibres which were of small diameter, and of the unmyelinated fibres, mainly due to axonal degeneration. Only two similar cases with incomplete recovery were found in the literature. In our case, a complete recovery was observed. The cause of the condition is unknown.

Acute Disease↗

PubMed2003

Effects of alpha-lipoic acid on impaired gastric fundus innervation in diabetic rats.

Diabetes mellitus is a major cause of neuropathy, leading to adverse effects including autonomic gastrointestinal dysfunction. Oxidative stress contributes to the etiology of diabetic neuropathy. The aim was to examine whether treatment with the antioxidant, alpha-lipoic acid (LA), could prevent or correct diabetic functional defects in the gastric fundus non-adrenergic, non-cholinergic (NANC) nerves, which use nitric oxide as their major neurotransmitter. LA (100 mg/kg/d) was given in a prevention study for 8 weeks following streptozotocin-diabetes induction, and in an intervention study for 4 weeks after 4 weeks of untreated diabetes. Fundus strips were studied in vitro after precontraction with 5-hydroxytryptamine in the presence of guanethidine and atropine to isolate NANC relaxation to electrical field stimulation. After 4 and 8 weeks of diabetes, there were 26% and 48% deficits in maximum relaxation, respectively. Prevention LA treatment gave 83% protection; intervention LA prevented the deterioration between 4 and 8 weeks of diabetes and corrected the initial 4 week deficit by 56%. Diabetes also resulted in a failure to maintain relaxation for prolonged stimulation, which was prevented by LA. Thus, LA prevented and reversed the development of impaired gastric fundus NANC responses in diabetic rats, which has potential therapeutic implications for gastrointestinal autonomic neuropathy.

Animals↗

PubMedDate not supplied

Clinical pharmacokinetics of cyclosporin.

Cyclosporin (cyclosporin A) is a unique immunosuppressant used to prevent the rejection of transplanted organs and to treat diseases of autoimmune origin. Therapeutic drug monitoring of cyclosporin is essential for several reasons: wide variability in cyclosporin pharmacokinetics has been observed after the oral or intravenous administration of the drug. The variability in the kinetics of cyclosporin is related to a patient's disease state, the type of organ transplant, the age of the patient and therapy with other drugs that interact with cyclosporin; maintaining a blood concentration of cyclosporin required to prevent rejection of the transplanted organ; minimising drug toxicity by maintaining trough concentrations below that which toxicity is most likely to occur; and monitoring for compliance since patient non-compliance with drug regimens is a significant reason for graft loss after 60 days. Clinical monitoring and pharmacokinetic studies of cyclosporin can be performed using different biological fluids (plasma, serum or whole blood) and different analytical techniques (radioimmunoassay or high pressure liquid chromatography). The available analytical methods provide different results when using blood, plasma, or serum. Comparison of therapeutic ranges and pharmacokinetic parameters should be made with careful attention given to the method of cyclosporin analysis. Following oral administration, the absorption of cyclosporin is slow and incomplete. Peak concentrations in blood or plasma are reached in 1 to 8 hours after dosing. The bioavailability of cyclosporin ranges from less than 5% to 89% in transplant patients; poor absorption has frequently been observed in liver and kidney transplant patients and in bone marrow recipients. Factors that affect the oral absorption of cyclosporin include the elapsed time after surgery, the dose administered, gastrointestinal dysfunction, external bile drainage, liver disease, and food. Cyclosporin is widely distributed throughout the body. Following intravenous administration, the drug exhibits multicompartmental behaviour. The volume of distribution (whole blood; HPLC) ranges from 0.9 to 4.8 L/kg. Cyclosporin is highly bound to erythrocytes and plasma proteins and has a blood to plasma ratio of approximately 2. In plasma, approximately 80% of the drug is bound to lipoproteins. The distribution of cyclosporin in blood can be affected by a patient's haematocrit and lipoprotein profile. Cyclosporin is extensively metabolised, primarily by mono- and dihydroxylation as well as N-demethylation, and is considered a low-to-intermediate clearance drug.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗

PubMed2004

A traditional herbal medicine, rikkunshi-to (TJ-43), prevents intracellular signaling disorders in gastric smooth muscle of diabetic rats.

Prevention of diabetic gastrointestinal dysfunction is of utmost importance. The present study demonstrated that diacylglycerol kinase (DGK) activity in diabetic gastric smooth muscle in the resting state was approximately 3.5-fold greater than that in controls. However, oral administration of TJ-43 (1% of food intake) or subcutaneous insulin injection (12 units/kg/day) in streptozotocin-induced diabetic rats (DM) for 2 weeks prevented DGK abnormalities based on the control level. Increased DGK activity in the resting state of DM was inhibited significantly by R59022, neomycin or staurosporine; in contrast, these drugs did not affect DGK activity in controls, insulin-treated DM or TJ-43-treated DM. In controls, the endogenous phosphatidic acid (PA) level was inhibited significantly by R59022 or neomycin but not affected by staurosporine. On the other hand, these three drugs significantly inhibited endogenous PA levels in DM, and neomycin significantly inhibited endogenous PA levels in insulin-treated and TJ-43-treated DM. This suggests that TJ-43 could prevent alteration of DGK activity and PA formation without reduction of blood glucose levels. Moreover, these effects were greater than those of insulin treatment. Results suggested that TJ-43 treatment influenced the hyperreactivity of DGK and DAG formation via phospholipase C activity. In conclusion, TJ-43 can be recommended with respect to enhancement of the quality of life in patients displaying diabetic gastrointestinal complications.

Animals↗

PubMed1990

Identical orocecal transit time and serum motilin in hyperthermia and normothermia.

Fever, exercise, and exposure to a hot environment can all cause symptoms of gastrointestinal dysfunction as they elevate body temperature. Nonetheless, the link between hyperthermia per se and these symptoms is unknown. To test the functional significance of increased body temperature, we investigated the influence of substantial passive hyperthermia on orocecal transit in 12 young, healthy men. Transit time was determined by a consistent rise in H2 concentration in a rebreathing apparatus after oral ingestion of 0.7 g lactulose/kg body weight. Lactulose was given in combination with a 350-ml liquid meal (360 kcal). After raising core temperature in warm water to 38.3 degrees C, orocecal transit time was identical to control (90 +/- 13 min at 38.3 degrees C, 92 +/- 13 min at 37.1 degrees C). While hyperthermia did elevate heart rate and minute ventilation, serum motilin, gastrin, and cortisol were similar in the two conditions. The failure of a passive core temperature rise to alter mouth-to-cecum transit suggests that this aspect of alimentary function is independent of body temperature.

Adult↗

PubMed1989

Gastrointestinal manifestations of the acquired immunodeficiency syndrome.

AIDS-related gastrointestinal disease is common, presenting a challenge to all nutritional support clinicians. Patients frequently suffer from weight loss, diarrhea, malabsorption, and cachexia. Many factors complicate the course of AIDS-related gastrointestinal disease, including decreased food intake (resulting from fatigue and malaise), increased metabolic demand and nutritional requirements, and identifiable gastrointestinal pathology. Gastrointestinal pathology is well-documented, and in approximately 50% of persons with AIDS-related gastrointestinal disease, a causative agent can be identified. In general, treatment of AIDS-related gastrointestinal disease is not always curative. Much of the chronic gastrointestinal dysfunction is caused by recurring opportunistic pathogens that are resistant to chemotherapy. Often, patient care and long-term management can focus only on fluid and electrolyte balance, nutritional support, and symptom control. Even clinically stable patients have been diagnosed as chronically malnourished and, for reasons that remain unclear, are prone to rapid nutritional deterioration during disease exacerbations. Published reports of nutritional assessment and intervention in persons with AIDS are now appearing in the literature. However, the eventual mortality associated with AIDS still results in a hesitancy on the part of many clinicians to prescribe aggressive nutritional support, especially parenteral nutrition. Who to treat and at what stage of illness becomes the question. As new agents, such as AZT, are prescribed on a more frequent basis for persons with AIDS, the use of nutritional support as adjunctive therapy early in the course of disease becomes an issue. Although improving nutrition has not been shown to reverse any of the cellular immunodeficiency caused by HIV infection, quality of life may be improved. In specific cases, nutritional support, whether through diet counseling, food programs, or intervention with enteral or parenteral nutrition, appears to improve strength and endurance, thus enhancing quality of life.

Acquired Immunodeficiency Syndrome↗

PubMed1989

Reactive hypoglycemia.

Reactive hypoglycemia is a relatively uncommon meal-induced hypoglycemic disorder. Most patients with adrenergic-mediated symptoms have a diagnosis other than reactive hypoglycemia. In many patients with this self-diagnosis, other disorders can be attributed as a cause for symptoms, especially neuropsychiatric disease. The continued use of the terminology "functional hypoglycemia" only contributes vagueness to our correct understanding of this metabolic condition. There are a number of conditions associated with postprandial hypoglycemia. One category is the reactive hypoglycemias, which occur in patients with diabetes mellitus (diabetes reactive hypoglycemia), gastrointestinal dysfunction (alimentary reactive hypoglycemia), hormonal deficiency states (hormonal reactive hypoglycemia), and a large patient group characterized as having idiopathic reactive hypoglycemia. Of these causes the alimentary, hormonal, and diabetic patients are less disputed, whereas the idiopathic reactive hypoglycemic group has been referred to as a "nondisease" group. Characteristic alterations in insulin secretion accompany each of these conditions. In bona fide patients, dysinsulinism or hyperinsulinism usually accounts for the hypoglycemia. Some patients may have increased insulin sensitivity, but this association is doubtful or very rare. Patients with this meal-related eating disorder are characterized as ingesting excessive quantities of refined carbohydrate. In the research setting, the disorder can easily be elicited with the oral glucose tolerance test. However, to establish clinical relevance, the hypoglycemia needs documentation in the home setting with measurements of blood glucose during a postpradial symptomatic episode. The reactive hypoglycemic patients are frequently confused with patients with underlying psychiatric illness. Both syndromes are similar, with adrenergic-mediated symptoms and a common characteristic personality as noted on Minnesota Multiphasic Personality Inventory (MMPI) testing. Patients with bona fide meal-related reactive hypoglycemia should be treated primarily with dietary restriction of refined carbohydrates; other patients may require medications.

Blood Glucose↗

PubMed1997

Changes in gut neurotensin and modified colonic motility following whole-body irradiation in rat.

Exposure to ionizing radiation induces gastrointestinal dysfunction often associated with disorders of intestinal motility. Neurotensin is one of the mediators involved in the control of intestinal muscle activity. The aim of this study was to relate neurotensin tissue content and specific receptor binding with contractile effect of neurotensin in rat colon after irradiation. Rats were exposed to whole-body gamma-irradiation (60Co; 6 Gy). Intestinal (caecum, colon) neurotensin-like immunoreactivity, colonic muscle neurotensin receptor binding and neurotensin-induced contractions in isolated colon were investigated 3 and 7 days after irradiation. Irradiation produced a marked increase in the intestinal muscle content of neurotensin-like immunoreactivity (2.5-fold in caecum, 5-fold in colon) 3 days post-irradiation. At 7 days, the intestinal neurotensin content was close to that of the control values. Three days after irradiation, neurotensin receptors in colonic muscle were characterized by the appearance of a transient second class of sites of low affinity-high capacity. A three-fold increase in the total number of sites was observed. In addition, effects of neurotensin on isolated colon preparations showed an increase (37%) of potency but a decrease (7-fold) of efficacy. Seven days after irradiation, the efficacy was close to the control. Modifications of intestinal neurotensin content and specific receptor characteristics induced by irradiation can influence the colonic contractile activity.

Animals↗