PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “DUODENAL INTUBATION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed2005

Effect of peptide YY on pancreatico-biliary secretion in humans.

OBJECTIVE: The negative feedback on pancreatico-biliary secretion induced by ileal nutrients has been well documented but the role of the distal gut peptide YY (PYY) as mediator is less well defined. We determined the effect of PYY on basal, sham feeding and feeding-stimulated pancreatico-biliary secretion in humans. MATERIAL AND METHODS: Eight healthy volunteers participated in a placebo-controlled, double-blind, randomized study with intravenous infusion of a physiological dose of PYY. Subjects were intubated with a naso-jejunal tube. Duodenal samples were aspirated continuously while a recovery marker perfused the duodenum. Outputs were measured in the basal state, in response to modified sham feeding (MSF) and during jejunal perfusion with a liquid meal. Blood samples were drawn for plasma cholecystokinin (CCK) and PYY measurements. RESULTS: PYY infusion significantly (p<0.01) increased plasma PYY, from 16+/-2 to 55+/-6 pM. Basal outputs of amylase, lipase, trypsin and bilirubin were not affected by PYY. In the placebo experiment, MSF significantly increased amylase, lipase, trypsin and bilirubin outputs. However, during PYY infusion lipase, trypsin and bilirubin outputs did not significantly increase in response to MSF. Jejunal feeding, however, significantly (p<0.01) increased the outputs of bilirubin and enzymes equally during both the placebo and PYY infusions. CONCLUSIONS: Infusion of PYY to physiological plasma levels exerts an inhibitory effect on pancreatico-biliary secretion during the cephalic phase of digestion, but not in the basal state or during the intestinal phase. PYY suppresses pancreatico-biliary secretion during the cephalic phase but not during the intestinal phase of nutrient digestion.

Adolescent↗
PubMed2001

Effects of lansoprazole on human gastric lipase secretion and intragastric lipolysis in healthy human volunteers.

BACKGROUND: Lansoprazole is a potent proton-pump inhibitor (PPI) of parietal cells, which reduces the secretion of gastric acid. Although human gastric lipase (HGL) is produced only by the chief cells of the stomach, the possibility that interactions may occur between lansoprazole and HGL has never been addressed so far in humans. The aim of this study was therefore to quantify the effects of lansoprazole on HGL secretion and intragastric lipolysis during the ingestion of test meals by healthy human volunteers. METHODS: Six healthy volunteers were intubated twice with a gastric and a duodenal tube, before ingesting a standard liquid test meal alone (-PPI experiments) and after 7 days of lansoprazole treatment (+PPI experiments). The HGL concentration was assessed in gastric and duodenal samples by measuring the lipase activity using a pH-stat, and the lipolysis products were quantified by performing thin layer chromatography. The level of intragastric lipolysis was defined as the percentage acyl chains released from the meal triglycerides. The pyloric outputs of HGL and lipolysis products were calculated, based on the use of a non-absorbable marker added to the meal. RESULTS: The pH of the gastric contents was significantly higher in the +PPI experiments than in the -PPI experiments (p < 0.05), since mean values of 4.3 +/- 2.5 and 2.2 +/- 1.6, respectively, were recorded at the end of the gastric emptying of the meal. The HGL concentrations recorded during the meal were found to be higher in the experiments with lansoprazole (p < 0.05) than in those without lansopra- zole, but the HGL secretion levels (-PPI: 15.4 +/- 8.0 mg; +PPI: 19.0 +/- 7.4 mg) and the intragastric lipolysis (-PPI: 24.0 +/- 8.0%; +PPI: 23.6 +/- 6.8%) were not significantly affected by lansoprazole (p > 0.05 in both cases). CONCLUSION: Lansoprazole affected neither the HGL secretion nor the intragastric lipolysis levels, although an increase was observed in the intragastric pH at the end of the gastric emptying of the meal. The HGL concentration increased, however, due to the decrease in the acid secretion process, resulting in less diluted gastric contents.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1994

Effect of atropine and truncal vagotomy on the exocrine pancreatic function in dogs stimulated with intraduodenal tryptophan.

The purpose of this experimental study was to analyze the effect of different doses of atropine and bilateral transthoracic truncal vagotomy on pancreatic secretion. We chose the dog as our experimental model and used the modified Thomas method to obtain gastric juice, removing the gastric acid with a gastric cannula. An additional duodenal cannula was used for the selective intubation of the greater pancreatic duct in order to obtain pure pancreatic juice. To stimulate pancreatic secretion the pancreas was stimulated with intravenous secretin at a constant dose and intraduodenal tryptophan at gradually increasing doses. The juice was collected at 10-min intervals and volume, output of bicarbonate and protein were determined. The results obtained show that low doses of atropine (0.65, 1.25 and 5 micrograms/kg/h) strengthen the suppressive effect of truncal vagotomy on the hydrobicarbonate secretion. Greatest suppression was found in the highest dosage of atropine in response to the intraduodenal tryptophane at gradually increasing doses. The above results suggest the possible existence of local enteropancreatic cholinergic reflexes that are readily suppressed by atropine and vagotomy. Suppression is not global though, since there is no significant reduction in the pancreatic protein secretion, which shows a dosage-effect curve in response to the gradually increasing doses of intraduodenal tryptophan released by the action of endogenous cholecystokinin. Our hypothesis is that there exists a nonvagal enteropancreatic cholinergic reflex.

Animals↗
PubMedDate not supplied

A rural ambulance helicopter system in northern Sweden.

INTRODUCTION: In Sweden, several ambulance helicopter programs have been used during the past 3 decades. This article describes one of these programs. SETTING: The catchment area of the helicopter system under study was a typical rural setting with a population density of less than 5 people per square kilometer. METHODS: We describe in detail, with special reference to medical aspects, the activities of an helicopter ambulance program in 1997. RESULTS: A total of 288 missions, including 328 patients (204 men), were analyzed. Trauma cases (29%) and patients with cardiovascular (24%) and neurologic problems (13%) dominated the missions. One-sixth of the cases occurred at night. The median response time was 12 minutes, and the median on-scene time was 28 minutes. The medical interventions performed included intubations; central venous catheter, arterial needle, and duodenal tube insertions; and medication administered intravenously, orally, and intrabronchially. CONCLUSION: We detected a higher rate of trauma cases than in previously published investigations, probably related to the outdoor activities of the area. We believe that the rapid institution of thrombolytic treatment in suspected acute myocardial infarction and a more rapid and flexible transport of trauma cases in a rural area are important. We estimate that, in most cases, the helicopter service could provide a quicker transport than a ground ambulance; however, for short distance transports, ground ambulance is faster than helicopter ambulance.

Adolescent↗
PubMed1999

Prospective, randomized evaluation of early removal of nasogastric tubes in postceliotomy trauma patients.

The objective of this study is to compare early (24-hour) removal of nasogastric tubes (NGTs) in trauma patients who have undergone emergency celiotomy to removal based on clinical signs of return of bowel function. All trauma patients who underwent an emergency celiotomy between November 1994 and August 1997 were randomized to 24-hour NGT removal, or removal when flatus and decreased NG output indicated. Exclusion criteria included patients with duodenal or esophageal injuries, those with airway intubations that were >24 hours, or those who had undergone same-hospitalization repeat celiotomy. Gastric or severity of intestinal injury were not exclusion criteria. Failure of NGT removal was defined as pain, abdominal distention, and vomiting. Mechanisms of injury, Injury Severity Score, operative findings, NGT removal times, morbidity, laboratory data, and reasons for failure were evaluated. A total of 177 patients qualified for the study. Two patients were inappropriately randomized and subsequently excluded. Of the remaining 175 patients, 151 sustained penetrating injuries and 24 sustained blunt injuries. Of the 151 patients in the penetrating injury group, 68 were randomized to the 24-hour pull (study) group and 83 were randomized to the clinical pull (control) group. There were three failures in the study group [3 of 68 patients (4.4%)] and three failures in the control group [3 of 83 patients (3.6%)]. Of the 24 blunt injury patients, 10 were randomized to the study group and 14 were randomized to the control group. There was one failure in the study group [1 of 10 patients (10.0%)] and one failure in the control group [1 of 14 patients (7.1%)]. Overall failure rate for the study group was 5.1 per cent [(3+1)/(68+10) = 5.1%] versus 4.1 per cent for the control group. Overall failure for all patients in the study was 4.6 per cent. Injury severity score, morbidity, and lab values were not significantly different. It is safe to remove NGTs at 24 hours in most trauma patients regardless of the severity of injury (failure rate, 5.1%). The surgical dogma of the need to have an NGT in longer for blunt trauma was not revealed in this study, however, a larger study would be needed to determine this with significance.

Abdominal Injuries↗
PubMed2000

Assessment of the carcinogenicity associated with oral exposures to hydrogen peroxide.

Concern regarding hydrogen peroxide (H(2)O(2)) carcinogenicity arises from its ability to act as a strong oxidizing agent. In short-term genotoxicity tests, H(2)O(2) has given predominantly positive results; however, these assays have been performed using either bacterial strains engineered to be exquisitely sensitive to oxidant damage, or mammalian cells deficient in antioxidant enzymes. Significantly, the addition of antioxidant protective measures (normally present in vivo) to these assay systems protects against H(2)O(2) genotoxicity. In most whole animal studies, H(2)O(2) exposure neither initiates nor promotes tumors. In mice, however, 0.4% H(2)O(2) in drinking water was reported to induce hyperplastic lesions of the duodenum and to erode areas in the glandular stomach epithelium. Owing to the chemistry of dilute H(2)O(2) solutions and the anatomy/physiology of the gastrointestinal tract, it is unlikely that orally ingested H(2)O(2) reaches the duodenum. Instead, greatly decreased water consumption and the resultant abrasion of the luminal lining on ingestion of pelleted dry rodent chow is the most likely cause of the observed gastric and duodenal lesions following H(2)O(2) administration in drinking water. Significantly, when hamsters received high doses of H(2)O(2) by gastric intubation (and water intake was not affected), the gastric and duodenal epithelia appeared normal. In-depth analysis of the available data supports the conclusion that oral ingestion of H(2)O(2) should not be considered a carcinogenic threat.

Administration, Oral↗
PubMed1987

HCO3- secretion in rat duodenum after treatment with omeprazole and ranitidine.

The bicarbonate secretion by the duodenal mucosa, which is stimulated by luminal acid, is very probably important in mucosal protection against the acid. It was of interest to investigate whether long-term deprivation of the mucosa of this acid stimulus affected the alkali secretion. Sprague-Dawley rats were treated for 4-6 weeks with either omeprazole, 14 mg/kg body weight twice daily, or ranitidine, 300 mg/kg twice daily, by means of gastric intubation. The rate of bicarbonate secretion by the duodenal mucosa was determined in situ by continuous titration. Neither the basal secretion nor the increase in secretion in response to stimulation by prostaglandin E2 or luminal acid (pH 2.0 for 5 or 60 min) differed in treated animals from that in controls that had received placebo (p greater than 0.05). Thus, 4-6 weeks of treatment with omeprazole or ranitidine did not reduce duodenal mucosal bicarbonate secretion in the rat, nor did these drugs diminish the ability of this mucosa to respond to prolonged luminal acidification or luminally administered prostaglandin E2.

Animals↗
PubMed1984

Duodenal uptake of lead by suckling and weanling rats.

The aim of the current study was to determine the site of absorption of Pb by suckling rats. When 203PbCl2 (carrier-free) plus Pb-acetate (50 micrograms/g BW) was intragastrically administered to rat pups aged 10 and 14 days, mucosal uptake of Pb, measured 2 h after intubation, was manyfold greater in the duodenum than in other regions of the small intestine. By 24 days of age, this duodenal uptake was no longer apparent. In suckling pups the duodenal content of Pb became undetectable by 24 h postintubation; in contrast, ileal uptake was minimal at 2 h but increased progressively through 24 h. The ileal uptake component was also age-dependent, having disappeared by 24 days of age. These findings suggest that it is the duodenum where Pb absorption occurs, whereas ileal uptake represents intestinal retention. To assess the role of the milk diet in the elevated Pb absorption by the duodenum of suckling animals, the effect of fasting following intubation was determined. The duodenal uptake of Pb was substantially higher in fasted pups than in suckled littermates. Correspondingly, blood Pb levels were more than 4-fold higher in fasted pups than in suckled pups. We conclude that the enhanced absorption of Pb in the suckling rat is due to duodenal absorption and that this absorptive process is even further enhanced in the absence of milk.

Animals↗
PubMedDate not supplied

[The use of the Dreimlich probe for obtaining samples in a postoperative study of biliopancreatic function in cholecystectomized patients].

We have performed a clinical study involving patients with symptomatic gallstones and indications for surgery, to analyze the biliary and pancreatic response to the quality of dietary fat (degree of unsaturation). As part of the investigative method, we have designed a clinical protocol adapted to the needs of the study, in this respect, we have used gastrointestinal intubation to obtain independent samples of gastric and duodenal juices, by means of a long nasoduodenal tube or a modified Dreimlich tube, placed manually in the intraoperative period, during the cholecystectomy. The characteristics of the tube are such that its manipulation is difficult, which led to situations postoperatively and during sampling, which may alter or invalidate the obtained drainage material. In the present study we define the protocol and the phases of the investigation, and we reflect on the usefulness of the Dreimlich tube as a method, analyzing its advantages and disadvantages.

Biliary Tract↗
PubMed1997

Duodenal and ileal nutrient deliveries regulate human intestinal motor and pancreatic responses to a meal.

It is assumed that in humans pancreatic and gastrointestinal motor responses to a meal are coordinated and regulated mainly by duodenal nutrient exposure. On the other hand, there is evidence that the distal intestine may participate in the regulation of gastrointestinal functions. The aim of this study was to compare human pancreatic and intestinal motility responses to a meal and to correlate them with nutrient exposure of the proximal and distal intestine. After intubation with an oroileal multilumen tube for marker perfusion, duodenal and ileal aspiration, and intestinal manometry, 14 healthy subjects received a mixed test meal (1,257 kJ). Intraluminal nutrient concentrations, enzyme activities, and small intestinal motility were analyzed for 6 h postprandially. Duration of duodenal nutrient exposure was 3.4 +/- 0.2 h, and duration of pancreatic enzyme response and fed motor pattern was 2.5 +/- 0.2 and 3.5 +/- 0.3 h, respectively. Durations of pancreatic secretory and motor responses were correlated (P < 0.05), but neither duration of digestive secretory nor of motor activity correlated with that of prandial duodenal nutrient concentrations. By contrast, they were associated with the relative increase in ileal nutrient delivery late postprandially (P < 0.05). Physiological late postprandial delivery of nutrients to distal intestinal sites is correlated with the termination of digestive pancreatic and motor responses and may participate in their control.

Adult↗
PubMed2005

Do elevated plasma vasoactive intestinal polypeptide (VIP) levels cause small intestinal motor disturbances in humans?

Increased VIP plasma levels cause severe secretory diarrhea. Moreover, VIP is a major regulator of human intestinal motility. We hypothesized that VIP-mediated intestinal motility disturbances contribute to symptoms in elevated plasma VIP. Ten healthy volunteers were intubated twice with an orojejunal multilumen tube for duodenal manometry, jejunal perfusion of electrolyte and marker solution, and aspiration 10 and 40 cm more distally. All subjects randomly received intravenous infusion of saline and 300 pmol/kg x hr VIP for 5 hr. Results showed that VIP but not saline infusion induced netjejunal sodium secretion, watery diarrhea, and cardiovascular effects (P < 0.04). VIP did not alter intestinal motor activity or the mean duration of the interdigestive motility cycle or of phases I and II but nearly halved the duration of phase III (P = 0.0002). We conclude that increased plasma VIP markedly shortens human phase III activity without influencing other motility parameters. Hence, it is unlikely that VIP-mediated small intestinal motor disturbances cause symptoms in VIPOMA. Yet VIP may contribute to terminate phase III motility.

Gastrointestinal Motility↗
PubMed1997

Spontaneous duodenal hematoma in a patient with Glanzmann's thrombasthenia.

Spontaneous intramural duodenal hematoma is a rare problem, most commonly seen in children who have coagulation disorders. A child who had Glanzmann's thrombasthenia, a disorder of platelet function, presented with signs and symptoms of duodenal obstruction. Nonoperative management of an obstructing duodenal hematoma was successful and potentially life-threatening surgery was avoided.

Abdominal Pain↗
PubMed1997

Foramen magnum decompression for cervicomedullary encroachment in craniometaphyseal dysplasia: case report.

OBJECTIVE AND IMPORTANCE: Foramen magnum encroachment has been cited as a potential cause for the premature demise of patients afflicted with craniometaphyseal dysplasia (CMD). To our knowledge, the association of Chiari malformation and syringomyelia with CMD has not been previously reported. We describe our evaluation and surgical treatment of a patient presenting with CMD, foramen magnum stenosis, Chiari I malformation, and syringomyelia. CLINICAL PRESENTATION: A 15-year-old female patient with CMD presented with severe headaches and progressive myelopathy. Evaluation by computed tomography and magnetic resonance imaging revealed mild ventriculomegaly, cervicomedullary compression secondary to Chiari I malformation and foramen magnum stenosis, and C3-T10 syringomyelia. INTERVENTION: Foramen magnum decompression was performed via suboccipital craniectomy, C1-C2 laminectomy, and dural augmentation. Dysplastic bone was revealed to be extremely thick and mineralized. Removal required lengthy and extensive drilling. The postoperative course was complicated by prolonged intubation secondary to airway obstruction and a perforated duodenal ulcer. Airway obstruction was attributed to severe nasopharyngeal bony dysplasia and soft tissue edema. The use of steroids in the treatment of airway edema and delayed enteral feeding was thought to contribute to ulcer development. Nevertheless, neurological symptoms improved dramatically. CONCLUSION: Foramen magnum decompression can be used to treat life-threatening cervicomedullary compression in patients with CMD. However, caution should be used because surgical intervention may be associated with a higher incidence of complications because of lengthy procedures and the spectrum of craniofacial impairments in patients with CMD.

Adolescent↗