PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “gastrointestinal dysfunction”

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 433 records · Page 24Linked to original sources
PubMed2003

Cyclo-oxygenase II inhibitors in the treatment of neoplastic fever.

Neoplastic fever is relatively common in cancer patients. Naproxen is one of the most commonly used non-steroidal anti-inflammatory drugs for the treatment of neoplastic fever. Naproxen is associated with platelet dysfunction and gastrointestinal side effects. We substituted rofecoxib, a cyclooxygenase-II inhibitor, for naproxen in patients with a previous history of, or a newly diagnosed, neoplastic fever in whom naproxen was relatively contraindicated. In all patients the fever resolved completely without any side effects.

Cyclooxygenase 2↗
PubMed1983

Beta-adrenoceptor blocking drugs: adverse reactions and drug interactions.

Beta adrenoceptor blocking drugs are relatively well tolerated and adverse reactions to them are not common. The ones that do occur are reviewed in this paper under the following headings: Short term adverse reactions, drug interactions, long term adverse reactions, risks in pregnancy and hazards of abrupt withdrawal. Predictable short term effects may be caused either by the actions of these drugs on the beta 1- or beta 2-receptors. The beta 1 adverse effects are hypotension, bradycardia and cardiac failure; these are best avoided by not giving beta-adrenoceptor blocking drugs to susceptible patients with cardiac disease. The beta 2 adverse effects on the bronchi, the peripheral arteries and various metabolic functions may be reduced to some extent by using a relatively cardioselective drug. Unpredictable short term effects such as fatigue, sexual dysfunction and gastrointestinal symptoms may occur but are not common problems with this group of drugs. Similarly, serious drug interactions are infrequent. Under the heading of long term adverse effects the practolol problem and the risk of causing malignant disorders have been considered. There is no evidence that any of the currently available drugs will cause either a practolol syndrome or malignant disease in man. However, the need for careful appraisal by drug regulatory bodies and continued vigilance by all prescribers of beta-adrenoceptor blocking drugs remains. The possible adverse effects of treatment during pregnancy are also considered. It now appears that beta-adrenoceptor drugs can be used safely in pregnancy but since neonatal bradycardia and hypoglycemia may occur, care should be taken to look for these complications. A serious deterioration may occur when beta-adrenoceptor drugs, given to patients with significant ischemic heart disease, are suddenly stopped. This is a rare occurrence but prescribers should be aware of it.

Adrenergic beta-Antagonists↗
PubMed1983

Acute side effects and late complications after radiotherapy of localized carcinoma of the prostate.

In the last two decades, many authors have treated prostatic carcinoma by radiation therapy. Accumulated data have been updated, after 10 and 15 years of follow-up. In stage A and B, the reported survival and local control rates after irradiation (20, 22, 30, 34, 35, 39, 42) are as good as in selected patients treated by radical prostatectomy (9, 18, 23). In stage C, the results after irradiation (20, 22, 30, 42) are better than after radical surgery (23, 43). However, patients are nonrandomly selected and the methods of statistical analysis differ. Therefore, a valid comparison cannot be made. The therapeutic ratio is determined by survival and local control, and also by therapy related complications. It is therefore of interest to find out from radiotherapy series if their incidence is related to the treatment technique. Unfortunately, relatively few studies accurately describe treatment technique and complications. Gastro-intestinal radiation injury becomes significant when the dose at the posterior rectal wall is 65-76 Gy and the length of the treated rectum is at least 10 cm. A hot spot of 80-84 Gy needs to be only 2 to 3 cm to increase the risk of late bowel stenosis. Genito-urinary complications are influenced by local extension of the tumor and by previous surgical manipulations. A dose at the prostatic area exceeding 70 Gy should be avoided, as it does not improve local control (22, 35) and apparently increases the risk of late urethral stricture and penile/scrotal edema (12, 39). The dose at the anterior bladder wall correlates with other types of genito-urinary complications. Therefore, the anterior bladder wall should not receive a dose higher than 65 Gy. Incidence of impaired potency after irradiation is usually 30 to 40%, which is much less than after radical surgery. As many data in the literature dealing with radiation treatment of the prostate are still inadequate a more standardized reporting is recommended to make comparison of effectiveness and side effects possible.

Adenocarcinoma↗
PubMed1985

Improving the therapeutic ratio of external beam irradiation for carcinoma of the prostate.

From 1975 to 1983, 240 patients with carcinoma of the prostate, Stages A2 to C, were treated with whole pelvic radiation followed by a 2-week rest and then a reduced field of radiation. The reduced prostatic field was evaluated for adequacy of tumor coverage by CT scan or ultrasound. The local regional control rate was 94%, with a 5-year actuarial survival for all stages of 72%. Severe complications occurred in 3% of patients and moderate complications in 13%. Two major factors that were identified as contributing to the risk of complications included previous or subsequent surgical intervention. Our technique of external beam radiotherapy resulted in a favorable therapeutic ratio, that is, excellent local-regional control with minimal morbidity.

Aged↗
PubMed1996

Mitochondrial encephalomyopathies presenting with features of autonomic and visceral dysfunction.

Three children are reported with mitochondrial encephalomyopathy who presented with autonomic dysfunction. Autonomic dysfunction included gastrointestinal dysmotility, apnea, cardiac arrhythmias, decreased lacrimation, supersensitivity to metacholine, altered sweating, and postural hypotension. These patients illustrate that in some mitochondrial encephalomyopathies autonomic features may be prominent and can mimic the clinical features associated with hereditary sensory and autonomic neuropathies.

Autonomic Nervous System Diseases↗
PubMed2004

Coronary surgery in patients with peripheral vascular disease: effect of avoiding cardiopulmonary bypass.

BACKGROUND: An increasing number of patients with peripheral vascular disease are undergoing coronary artery bypass grafting. Such patients have an increased risk of adverse outcomes. Our aim was to quantify the effect of avoiding cardiopulmonary bypass in this group of patients. METHODS: Between April 1997 and March 2002, 3,771 consecutive patients underwent coronary artery bypass grafting performed by five surgeons. Four hundred and twenty-two (11.2%) had peripheral vascular disease and of these, 211 (50%) received off-pump surgery. We used multivariate logistic regression analysis to assess the effect of off-pump surgery on in-hospital mortality and morbidity, while adjusting for treatment selection bias. Treatment selection bias was controlled for by constructing a propensity score, which was the probability of receiving off-pump surgery and included core patient characteristics. The C statistic for this model was 0.8. RESULTS: Off-pump patients were more likely to have preoperative renal dysfunction, previous gastrointestinal surgery, and less extensive disease. The left internal mammary artery was used more in off-pump compared to on-pump cases (90.1% vs 82.9%; p = 0.033). In the univariate analyses, off-pump patients were less likely to have a postoperative stroke (p = 0.007), and had shorter postoperative hospital stays (p < 0.001). However, the incidence of new atrial arrhythmia was higher (p = 0.028). After adjustment for differences in case-mix (propensity score), avoidance of cardiopulmonary bypass was still associated with a significant reduction in postoperative stroke (adjusted odds ratio 0.09 [95% confidence interval 0.02 to 0.50]; p = 0.005), and shorter postoperative hospital stay (p = 0.001). CONCLUSIONS: Off-pump coronary surgery is safe in patients with peripheral vascular disease, with acceptable results. The incidence of postoperative stroke is substantially reduced when avoiding cardiopulmonary bypass in patients with peripheral vascular disease.

Aged↗
PubMed2006

N-hexacosanol reverses diabetic induced muscarinic hypercontractility of ileum in the rat.

Diabetic neuropathy, a major complication of diabetes mellitus, is associated with development of gastrointestinal motility dysfunction and autonomic neuropathy. N-hexacosanol has neurotrophic effects and exhibits a wide variety of biological actions. In this study, we investigated the effects of cyclohexenonic long-chain fatty alcohol (N-hexacosanol) on streptozotocin-diabetic hypercontractility in the rat ileum longitudinal muscles. Treatment with N-hexacosanol did not alter the diabetic status of the animals, i.e., body weight, serum glucose, and serum insulin levels, but significantly restored the thickness of intestine wall and ameliorated diabetes-induced hypercontractility of the rat ileum in a dose-dependent manner. Furthermore, N-hexacosanol reversed the diabetes-induced upregulation of intestinal muscarinic M(2) and M(3) receptors mRNAs in the streptozotocin-diabetic rats. These results indicate that N-hexacosanol has therapeutic effects on hypercontractility in the diabetic ileum by ameliorating overexpression of muscarinic M(2) and M(3) receptors mRNAs.

Animals↗
PubMed2005

Clinical characteristics and surgical results of patients with cerebral arteriovenous malformations.

BACKGROUND: Cerebral arteriovenous malformation (AVM) is a common vascular disease in neurosurgery, and the indication for alternative treatments remains controversial. In a review of a series of 2086 patients with AVMs, the clinical characteristics and surgical results were assessed. METHODS: Collected data of 2086 consecutive patients with AVMs from January 1956 to October 2001 were analyzed. All patients were divided into 2 groups: traditional surgery group (from 1956 to 1991) and microsurgery group (from 1992 to 2001). The variables assessed for clinical characteristics in our study included age (at presentation), sex, Spetzler-Martin grade, and first presentations. Surgical complications were assessed between different surgery groups by chi(2) test. RESULTS: Cerebral AVMs are more commonly diagnosed at age of 20 to 40 years, which comprises almost one half of the whole population. The size of the AVMs ranged from 1 to 9 cm. There were 77 cases of giant AVMs in this series that were treated by a combination of surgical resection and intraoperative embolization. Hemorrhage (43.4%), headache (24.9%), and seizure (17.3%) were the first 3 common presentations. Regarding Spetzler-Martin grading system, the percentage of grade 3 to 5 patients increased, whereas that of grade 1 patients decreased in the microsurgery group (P = .00). However, compared with the traditional surgery group, the incidence of main surgical complications (death, hemiparalysis, cranial nerve dysfunction, and gastrointestinal hemorrhage) decreased significantly in the microsurgery group (P = .00). Although the incidence of main surgical complications had no statistical difference between early (from 1992 to 1996) and late microsurgery subgroup (from 1997 to 2001) (P = .796), the incidence really decreased with increase of higher-grading patients (grade 3-5) in the late microsurgery group (P = .00). CONCLUSIONS: Cerebral AVM is one of the important reasons for spontaneous intracranial hemorrhage in patients younger than 40. Spetzler-Martin grading system is helpful to predict the surgical risk. Microsurgical technique has made surgical treatment safer and become the best choice for patients with cerebral AVM.

Adolescent↗
PubMed1976

Clinical technique and success of the esophageal stent to prevent corrosive strictures.

The Reyes technique for the management of severe, acute corrosive injuries of the esophagus has been modified and successfully applied to two children and one adult whose cases are reported. None developed stricture and two were uncomplicated. Esophagomegaly, motility dysfunction, upper gastrointestinal bleeding, and pneumonitis complicated the hospitalization of one child whose subsequent course has been asymptomatic. Until more experience can be recorded, widespread use is not yet recommended.

Age Factors↗
PubMed1999

Age-induced changes in the enteric nervous system in the mouse.

The enteric nervous system of the murine gut was investigated by immunocytochemistry in 1-, 3-, 12- and 24-month-old mice, using protein gene product 9.5, a general marker for nerve elements. Myenteric and submucosal plexi were quantified by computerized image analysis. In antrum, there were significantly fewer neurones per ganglion in both myenteric and submucosal ganglia of 12- and 24-month-old mice than in 3-month-old animals. The same was true of duodenum and colon. The relative volume density of nerve fibres in antral muscularis propria was significantly greater in the 1-, 12- and 24-month-old mice than in the 3-month-old mice. In colon, there were fewer submucosal ganglia per millimetre baseline in 1-month-old mice than in 3-month-old mice. The colonic myenteric ganglion in 1-, 12- and 24-month-old mice was smaller than in 3-month-old mice. There was no statistical difference between females and males regarding the number of ganglia per millimetre baseline, ganglionic area, number of neurones per ganglion or the relative volume density of nerve fibres in either the myenteric or submucosal plexi. As the enteric nervous system is responsible for coordinating and integrating the motility of the gut, the ageing-related changes reported here may well be of some relevance for the increased gastrointestinal motility dysfunction in the elderly persons.

Aging↗
PubMed2003

Quality-of-life questionnaire results 2 and 3 years after radiotherapy for prostate cancer in a randomized dose-escalation study.

OBJECTIVES: To assess patient-reported prostate cancer-specific quality of life 2 and 3 years after radiotherapy to the prostate in a randomized dose-escalation trial of 70 versus 78 Gy conducted from 1993 to 1998. METHODS: Two years after completing radiotherapy, a questionnaire that assessed bladder, rectal, and sexual function was sent to 301 patients in the study. Three years after treatment, a second questionnaire was sent to the 175 patients with adequate follow-up. RESULTS: Three years after radiotherapy, urinary incontinence was reported by 35% of patients, but only 6% required the use of a pad or other protective device. Patients reported increased leakage with a full bladder (urge incontinence) between the 2 and 3-year questionnaires (42% versus 50%; P = 0.03). At 3 years, 33% of patients reported rectal bleeding compared with 47% at 2 years (P = 0.006). Patients in the 78-Gy arm reported more frequent bowel movements at 3 years and less change in bowel function at 2 years than patients in the 70-Gy arm. Before radiotherapy, 84% of patients reported erections adequate for intercourse at least a few times during the previous year. After 2 and 3 years, this had decreased to 49% and 41%, respectively (P <0.02). CONCLUSIONS: By patient-reported questionnaire, 78 Gy produced an increase in bowel movement frequency and no increase in bladder or sexual side effects at 3 years compared with 70 Gy. Comparing the results 2 and 3 years after radiotherapy, the symptoms of rectal bleeding had improved, erectile function had decreased, and urinary urge incontinence had increased.

Adenocarcinoma↗
PubMed2001

Effect of the treatment of Helicobacter pylori infection on gastric emptying and its influence on the glycaemic control in type 1 diabetes mellitus.

Helicobacter pylori (Hp) infection plays a role in gastric emptying (GE) in type 1 diabetic patients and may have implications for glycaemic control. The aim of our study was to investigate this relationship. Gastric emptying was studied in 13 patients with type 1 diabetes and Hp infection. The Hp infection status was assessed by serology and urease breath test (UBT). In addition upper gastrointestinal endoscopy with gastric mucosal biopsy was performed to look for gastritis. A radionuclide-labeled solid meal was used to study GE before and after eradication therapy (amoxicillin, clarithromycin and omeprazole) for Hp infection. All patients were evaluated for autonomic and peripheral neuropathy and were asked for symptoms of gastrointestinal motor dysfunction. Blood glucose levels were determined before the meal and at 30,60,90 and 120 min after the start of the meal. Home blood glucose self-monitoring and HbA(1c) were performed to document glycaemic control during the study. Three months after treatment, five patients were free of Hp infection and were without gastritis (group I: no Hp infection, no gastritis); eight of the patients continued to have gastritis after treatment (group II) and of these eight patients, six had gastritis without Hp infection and two had gastritis plus persistent Hp infection. These last two patients were re-treated with eradication therapy. Patients with gastritis were re-evaluated 6 months after initial treatment; at which time four were now free of gastritis and were added to group I (n=9) while four continual to have gastritis although without Hp infection (group II, n=4). In group I, GE half-time showed an increase (30.6+/-10.3 min vs. 60.2+/-15.4 min; P<0.05) while no change (28.8+/-9.5 vs. 26.9+/-8.7 min; n.s.) was observed in group II. GE half-time was not altered by autonomic and peripheral neuropathy or blood glucose during solid meal test. HbA(1c) did not change significantly after treatment in either groups but the blood glucose levels were more stable in group I compared to group II. A delay in GE was observed with disappearance of gastritis associated to H. pylori infection after eradication treatment in patients with type 1 diabetes. This change in GE could help to stabilise the blood glucose levels in these patients treated with insulin before each meal.

Adult↗
PubMed1988

A clinical index to predict survival in acute renal failure patients requiring dialysis.

Recent advances in technology have not substantially changed the relatively low survival rate associated with acute renal failure (ARF). Several clinical prognostic variables and multivariate models have been reported to predict survival in individual patients, but these are either cumbersome to use or restrictive in their application. A straightforward clinical index has been developed to predict survival in ARF based on data obtained for all patients receiving dialysis for ARF at the University of Kansas Medical Center from November 1979 through October 1985. During this period, 126 patients received dialysis for ARF, with an overall survival of 25% (32/126). There were no significant differences between survivors and nonsurvivors in age, gender, or indication for dialysis. Eleven variables were statistically related to survival, and were reduced to five when clinically similar variables were combined or eliminated. A clinical survival index was based on these five easily determined variables that were significantly related to survival: systolic blood pressure less than or equal to 110 mm Hg, assisted ventilation, congestive heart failure, proven or suspected sepsis, and gastrointestinal (GI) dysfunction (bleeding, ileus, obstruction, or recent abdominal surgery). Survival was directly related to the number of factors present: zero, 62% (8/13); one, 44% (8/18); two, 30% (10/33); three, 19% (5/26); four, 0% (0/20); and five, 6% (1/16). This straightforward index, derived from easily obtained clinical data, is useful for judging survival prognosis in patients with ARF severe enough to warrant treatment with dialysis.

Acute Kidney Injury↗
PubMed1996

Immediately elevated postoperative serum branched-chain amino acids following effective GI decompression and enteral feeding.

Postoperative patients are hypercatabolic. They also suffer a degree of gastrointestinal (GI) dysfunction impairing nutritional intake. Safe enteral absorption had been limited to a maximum of 500 kcal provided over the initial 24 h in all previously reported regimens. Several days of negative nitrogen balance and diminution of serum branched-chain amino acids (BCAA) result. Some data suggest an association with suboptimal wound healing, and immune competence. We tested the hypothesis that immediate exploitation of more effectively preserved GI function could prevent this depressed serum concentration within hours of surgery. Our study group consisted of 34 consecutive elective "open" cholecystectomy patients who had terminal esophageal, gastric, and proximal duodenal decompression. Simultaneous distal duodenal feeding of elemental diet began immediately in the Recovery Room at 300 mL/h for 8-16 h, providing 2,400-4,800 kcal and 100-200 g amino acids. We found that each serum BCAA concentration rose above basal by one hour. The differences reached statistical significance (p < or = 0.05) within 2 h after surgery, when leucine had risen above basal levels by 70%, isoleucine by 63%, and valine by 26%. Elevations in these BCAA serum concentrations persisted for the duration of feeding. GI function can be maintained and successfully utilized in the immediate postoperative period for absorption of 300 kcal/h. Postoperative depression of serum BCAA concentrations are prevented. The serum BCAA rise of these GI protected and immediately fed postoperative patients contrasts with the 48-72 h decline universally reported with conventional protein- and calorie-deficient regimens. The optimum nutritional regimen for achievement of clinically significant enhanced wound healing, sepsis resistance, and muscle sparing, remains to be determined.

Adult↗
PubMed2002

Widespread changes in neurotransmitter expression and number of enteric neurons and interstitial cells of Cajal in lethal spotted mice: an explanation for persisting dysmotility after operation for Hirschsprung's disease?

Gastrointestinal motor dysfunction persists in a large number of children subjected to surgical treatment for Hirschsprung's disease, indicating abnormalities in the remaining intestine. The aim of the study was to detect possible alterations in frequency and topographic distribution of enteric neurons and interstitial cells of Cajal in an experimental model (the lethal spotted mouse displaying a short rectal aganglionosis) for Hirschsprung's disease. Specimens from the intestinal tract from homozygous (aganglionic) and heterozygous (healthy littermates) were examined using histochemistry, in situ hybridization, and immunohistochemistry. In ileum and colon, ie, regions proximal to the aganglionosis, changes in the expression of neuropeptides and neuronal nitric oxide synthase and in the number of enteric neurons and interstitial cells of Cajal could be detected in homozygous versus heterozygous mice. The described changes are suggested to contribute to the dysmotility remaining after surgical resection of the aganglionic segment in Hirschsprung's disease.

Animals↗
PubMed2006

The effects of chronic phosphodiesterase-5 inhibitor use on different organ systems.

Phosphodiesterase-5 (PDE-5) inhibitors selectively inhibit PDE-5 enzymes that are present in various tissues like penile tissue, platelets, vascular, and smooth muscle tissue. The drug's actions on these tissues have lead to the successful therapeutic use in patients suffering from conditions such as erectile dysfunction (ED) and pulmonary hypertension. PDE-5 inhibitors (PDE-5i) act on the erectile tissue causing penile smooth muscle relaxation and vasodilatation leading to penile erection. In addition, in particular when used in conjunction with prostaglandin inhibitors, PDE-5i cause vasodilatation in pulmonary vasculature hence decreasing both the pulmonary arterial pressure and resistance. PDE-5i have also shown to mildly decrease blood pressure, increase cardiac index, and increase coronary blood flow in experimental animals as well as in human studies. The Food and Drug Administration (FDA) has approved three PDE-5i for the treatment of ED: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) and one for pulmonary hypertension: sildenafil (Revatio). These agents are highly selective for PDE-5 enzymes as compared to other subclasses of PDE enzymes and have the almost identical pharmacological action but slightly different pharmacokinetics. Only little data exist about long-term use of PDE-5i and their effects on different organ system. This paper reviews the current information available on chronic PDE-5 inhibitor use.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2001

The Dutch cohort of sildenafil users: baseline characteristics.

OBJECTIVE: To identify a Dutch cohort of sildenafil users and describe their baseline characteristics. PATIENTS AND METHODS: Each pharmacy in The Netherlands (n = 1571) was asked to identify prospectively the first 20 sildenafil prescriptions in their pharmacy over 1 year, and to complete and return a registration form. The collected data included patient characteristics, the details of the sildenafil prescription (date, prescriber, number of prescriptions, dosing), and the use of co-medication by the patient in the year preceding the sildenafil prescription. RESULTS: Data were collected from 4460 sildenafil prescriptions during the year under study, relating to 3477 individual patients. Most of the cohort had cardiovascular morbidity or diabetes. Sildenafil seems to have been used by a new, previously untreated population of patients with erectile dysfunction. In addition, 69 men were identified who could have been using nitrates and sildenafil concomitantly. CONCLUSION: A cohort of patients using sildenafil was identified and characterized; they appeared to be representative of sildenafil users in The Netherlands. This cohort will be followed prospectively to evaluate the medical status (particularly cardiovascular) of the patients with time.

Adult↗