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PubMed2007

Erythropoietic and anti-obesity effects of Garcinia cambogia (bitter kola) in Wistar rats.

The anti-obesity and erythropoietic effects of crude ethanolic extracts of Garcinia cambogia (bitter kola) seeds on Wistar rats (Rattus norvegicus) were investigated. The rats were divided into three dosage groups: A (0 mg/kg of body weight), B (200 mg/kg) and C (400 mg/kg). Weight changes, plasma lipoprotein levels and the lipid profile of the liver, gastrointestinal system and adipose tissue were monitored as indices for anti-obesity, while the RBC (red blood cell) count (assessed by using a haemocytometer) was monitored as a measure of erythropoiesis. The extract was administered by gavage for 5 weeks. The results for each test group was compared statistically with those for the control (P<0.05). Analysis of the results showed a significant increase in RBC counts in both test groups and a decrease in weights of experimental animals. There was a dose-dependent decrease in the plasma level of very-low-density lipoprotein and a dose-dependent increase in the level of chylomicrons. There was a slight, but significant, decrease in the level of high-density lipoprotein and a significant increase in the level of LDL (low-density lipoprotein). There was significant dose-dependent decrease in the TAG (triacylglycerol) pool of adipose tissue and the liver of the test groups, but a significant increase in the TAG pool of the gastrointestinal system. The increase in the TAG pool of the gastrointestinal system is possibly compensatory. The results therefore confirm that ethanolic extracts of G. cambogia seeds have both haematologically enhancing and anti-obesity effects. The decrease in the high-density-lipoprotein level and an increase in the LDL level may play an important role in cardiovascular disease.

Animals↗
PubMed2005

The clinical efficacy and tolerability of doxazosin standard and gastrointestinal therapeutic system for benign prostatic hyperplasia.

The therapeutic goal of treating benign prostatic hyperplasia (BPH) through early detection and effective therapy is to relieve the symptoms, improve patients' quality of life, decrease postvoid residual urine volume, and prevent the associated morbidity when the condition remains untreated. Alpha1-adrenoreceptor antagonists, e.g. doxazosin, terazosin, tamsulosin and alfuzosin, relax the bladder outlet to improve urinary flow, by reducing prostatic smooth muscle tone through the blockade of sympathetic adrenergic receptors. Doxazosin gastrointestinal therapeutic system (GITS) is a controlled-release formulation developed to enhance the pharmacokinetic profile of the drug while simultaneously minimizing possible adverse effects and reducing the need for dose titration. While both doxazosin standard and GITS are indicated for hypertension, they are also useful in the pharmacologically or naturally normotensive patient with BPH. In a cross-over trial comparing doxazosin GITS and tamsulosin, doxazosin gave a significantly greater improvement from baseline in symptoms. Results from recent trials (e.g. Medical Therapy of Prostatic Symptoms, MTOPS) showed that doxazosin was significantly more effective than the 5alpha-reductase inhibitor finasteride in relieving lower urinary tract symptoms, irrespective of prostate volume. The MTOPS trial showed clearly that over the long term, the combination of doxazosin and finasteride was more effective than either agent alone in significantly improving symptoms and reducing the clinical progression of BPH. Both doxazosin standard and GITS are well-tolerated, long-term therapies that are equally effective in younger and older men, and not associated with causing sexual dysfunction.

Adrenergic alpha-Antagonists↗
PubMed2003

Iron deficiency anemia in the elderly: prevalence and endoscopic evaluation of the gastrointestinal tract in outpatients.

Iron deficiency anemia (IDA), mostly due to chronic occult bleeding from the gastrointestinal tract, is a common problem in the elderly. This study aimed to determine the prevalence of IDA in the elderly and to investigate the gastrointestinal tract in elderly patients with IDA. 1,388 patients over 65 years were prospectively evaluated for IDA in our outpatient clinic. IDA was defined if decreased hemoglobin concentrations (<13 g/dl for men and <12 g/dl for women) were associated with low serum ferritin levels (<15 ng/ml in men and <9 ng/ml in women). We evaluated the gastrointestinal system of all patients with IDA by upper gastrointestinal endoscopy and colonoscopy regardless of fecal occult blood loss. The prevalence of anemia was found to be 25% (n = 347) in our study population, and 30.5% (n = 106) of these patients with anemia had iron deficiency. Upper gastrointestinal endoscopy and colonoscopy were performed in 96 patients with IDA. Fifty-eight upper gastrointestinal system lesions (55 patients, 57.3%) and 27 colonic lesions (26 patients, 27.1%) were detected. We diagnosed gastrointestinal malignancy in 15 (15.6%) elderly patients with IDA (8 colon, 1 esophageal and 6 gastric cancers). IDA is a common problem in elderly patients; consequently, before iron replacement therapy, patients should be thoroughly investigated regarding a possible association with gastrointestinal malignancy.

Aged↗
PubMed2004

Comparison of the effects of telmisartan and nifedipine gastrointestinal therapeutic system on blood pressure control, glucose metabolism, and the lipid profile in patients with type 2 diabetes mellitus and mild hypertension: a 12-month, randomized, double-blind study.

BACKGROUND: Angiotensin receptor blockers (ARBs) provide effective blood pressure control. Whereas none of the ARBs appear to affect glucose homeostasis, some ARBs have been associated with a decrease in cholesterolemia. OBJECTIVE: This study was conducted to evaluate blood pressure control glucose homeostasis, and the plasma lipid profile in patients with type 2 diabetes mellitus and mild hypertension during 12 months of treatment with the ARB telmisartan or nifedipine gastrointestinal therapeutic system (GITS). METHODS: In this double-blind trial, patients taking oral hypoglycemic agents were randomized to receive telmisartan 40 mg or nifedipine GITS 20 mg once daily for 12 months. At the time of enrollment, patients were given advice on diet (1400-1600 kcal/d) and exercise (stationary bicycle for > or =30 min, 4 d/wk). Assessments of systolic blood pressure (SBP), diastolic blood pressure, body mass index (BMI), fasting plasma glucose concentrations, glycosylated hemoglobin, fasting plasma insulin concentrations, the homeostasis model assessment of insulin resistance, and the lipid profile were performed at baseline and after 6 and 12 months of treatment. RESULTS: One hundred sixteen patients were divided into 2 age- and sex-matched treatment groups (58 men, 58 women; mean [SD] age, 52.5 [5] years). All patients were in good general health at baseline; had achieved adequate glycemic control with diet and oral hypoglycemic agents; were taking antihypercholesterolemic drugs; and had no evidence of macroangiopathy, microalbuminuria, or neuropathy. There were significant reductions from baseline in seated trough SBP after 12 months of treatment with both telmisartan and nifedipine GITS (from 139 [4] to 132 [4] mm Hg and from 140 [4] to 130 [4] mm Hg, respectively; both, P < 0.01). No change in BMI or glucose metabolism was observed with either treatment. After 12 months, there were significant improvements in concentrations of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) with telmisartan (-9% and -11.5%, respectively; both, P < 0.01) compared with nifedipine GITS (-2% and -1.5%). CONCLUSIONS: In this selected sample of patients with type 2 diabetes and mild hypertension, both telmisartan and nifedipine GITS produced significant reductions in blood pressure. Telmisartan was associated with a slight but statistically significant improvement in plasma TC and LDL-C concentrations compared with nifedipine GITS.

Antihypertensive Agents↗
PubMed1994

Evolution of the gastrointestinal endocrine system (with special reference to gastrin and CCK).

The evolution of gut endocrine cells can be seen to have depended in the first instance on the expression of genes encoding regulatory peptides in cells that had evolved the regulated pathway of secretion. It seems probable that the endocrine cells made use of molecules and mechanisms that first emerged in early nervous systems. However, by the start of the vertebrate line of evolution, most of the major families of gut hormones were already found in association with endocrine cells. A single common class of receptor with seven transmembrane domains and acting via association with G-proteins transduces many (perhaps all) gut peptide actions. The duplication and divergence of receptors and peptides can now be traced, in outline at least, for gastrin and CCK in vertebrates. Even in phylogenetically similar groups such as birds and mammals, quite different molecular approaches have been applied to solving the same physiological problem. Evolution of the modern gastrointestinal control system evidently depended in this case both on molecular evolution of peptides and receptors and on cells expressing the genes encoding them.

Amino Acid Sequence↗
PubMed1987

Clinical pharmacokinetics of nifedipine gastrointestinal therapeutic system. A controlled-release formulation of nifedipine.

The pharmacokinetics of nifedipine following intravenous administration can be represented by an open two-compartment model with a terminal elimination half-life of about two hours. Nifedipine is extensively biotransformed to inactive metabolites, and the total body clearance (450 to 700 ml/minute) is primarily due to hepatic metabolism. Nifedipine undergoes significant tissue distribution in that the steady-state volume of distribution (0.62 to 0.77 liter/kg) is more than twice the volume of distribution of the central compartment (0.25 to 0.29 liter/kg). Although nifedipine is almost completely absorbed from the gastrointestinal tract, oral bioavailability ranges from 45 to 68 percent because of first-pass metabolism. Nifedipine given three times daily shows no accumulation in plasma and no changes in pharmacokinetic behavior during a one-week study period. Pharmacokinetic studies on the gastrointestinal therapeutic system (GITS) show that the bioavailability of the GITS dosage form (relative to the capsule) is about 65 percent after a single dose, but increases to about 86 percent at steady-state because of residual absorption more than 24 hours after dosing. Linear pharmacokinetics are seen following administration of single oral doses of nifedipine GITS as indicated by dose-proportional increases in the area under the plasma drug concentration-time curve over the range of 30 to 180 mg. Administration of the GITS dosage form in the presence of food slightly increases the rate of drug absorption, but does not influence the extent of drug bioavailability. Dose-dumping has not been observed, even with dosing after a meal containing a high level of fat. The GITS tablets provide zero-order delivery of nifedipine, and drug absorption persists beyond the dosing interval of 24 hours. Thus, the GITS dosage form will permit once-a-day dosing and maintain the desired, constant plasma drug concentration with minimal fluctuation.

Biological Availability↗
PubMed2001

[Metabolic disorders in nonspecific inflammatory bowel diseases].

The primary function of the gastrointestinal system is to assist the intake and further processing of food and liquids. Besides that, it forms an anatomical barrier between the external environment and internal milieu. It is also highly important for its paracrine and endocrine function. Inflammatory bowel diseases, which frequently cause a gastrointestinal failure, form a specific group. Most frequently it is the ulcerative colitis and Crohn's disease. Impaired integrity of the gastrointestinal mucosa and failure of protective mechanisms lead to the increased permeability of the intestinal wall for antigens derived from food, saprophytic bacteria and pathogenic microorganisms. When the gastrointestinal failure is threatening, factors determining its residual function become more important. As decisive reveals the severity and location of the primary disease. Previous surgeries and adaptation of the residual part of the gastrointestinal system are important, as well as the possibility of peroral or enteral nutrient intake. Depending on the presence of risk factors and the degree of residual gut function, some complications can be expected: dehydration, mineral disorders, symptoms of protein and energy depletion, infection, and multiple organ dysfunction syndrome. It is highly important to decide whether the gastrointestinal system will be included into or excluded from the process of realimentation. Critically ill patients with inflammatory bowel diseases should be treated at an intensive care unit.

Deficiency Diseases↗
PubMed1999

Immunodeficiency and the gut: clues to the role of the immune system in gastrointestinal disease.

Gastrointestinal disease occurs in a high proportion of patients with primary immunodeficiency. While enteric infections are responsible for the gastrointestinal pathology in many individuals, it is now clear that infection alone is not sufficient to explain the gut pathology found in many immunodeficiencies. This article focuses on recent developments in this field and highlights the insights gained in understanding the complex relationship between immunodeficiency and the gut.

Carrier Proteins↗
PubMedDate not supplied

Are the stool characteristics of preterm infants affected by infant formulas?

The aim of this study was to investigate the relationship between the type of formula consumed and the stool characteristics and gastrointestinal symptoms of preterm infants prospectively. Seventy-five preterm infants weighing < 2000 g in our neonatal intensive care unit (NICU) were investigated. Four groups of 15 each were fed one of four commercial formula preparations (Prematil, Neonatal, Humana-0 and S-26) and the fifth group was breast-fed in a prospective, randomized, double-blind study. The stool characteristics and gastrointestinal problems were recorded daily from the first day till the time they were discharged by the nurses of NICU. No significant differences of daily weight gain was observed between the groups. No significant difference was observed in daily frequency of stool, distention, vomiting and gas passage between the groups during the enteral + parenteral and full-enteral nutrition periods. The infants fed by Prematil during the enteral + parenteral nutrition period had a higher percentage of hard stool occurrence than infants receiving Humana-0 and breast milk. In the full-enteral nutrition period, infants receiving Prematil had a higher percentage of hard stool occurrence than all the other groups, whereas breast-fed infants had a lower percentage of hard stool than all the other groups. While the group fed with Humana-0 had a higher percentage of green stool occurrence in the enteral + parenteral nutrition period, no significant difference was observed in the full-enteral nutrition period. In the enteral + parenteral nutrition period no additional therapy affected stool characteristics or the gastrointestinal system except in the case of the infant receiving phototherapy for whom the daily number of detections was significantly high. In this study, it was shown that the color and consistency of stool in preterm infant differs according to the preterm infant formulas, but no differences were observed in the frequency of defecation or in gastrointestinal system problems. When the infant formulas were compared with breast milk, it was shown that they cause a higher percentage of hard stool occurrence. An increased number of formula feedings are necessary to obtain a similar daily weight gain, but the color and the frequency of the stool and the gastrointestinal system problems were similar for breast-fed and formula-fed infants.

Breast Feeding↗
PubMed1990

Endocrine and renal effects of nifedipine gastrointestinal therapeutic system in patients with essential hypertension. Results of a multicenter trial. The Modern Approach to the Treatment of Hypertension Study Group.

Use of thiazide diuretics and beta-blockers in the treatment of hypertension may result in metabolic derangements and/or disturbances in the parameters of renal function, which offset the benefits of blood pressure reduction by adversely affecting other cardiovascular risk factors, particularly in special patient groups such as the elderly or those with concomitant diseases. Newer agents including calcium channel blockers, which exert potent antihypertensive effects without adversely affecting metabolic parameters unfavorably, are used with increasing frequency in hypertensive patients, but their clinical utility has been limited by the need for multiple daily dosing with attendant fluctuations in plasma levels thought to be associated with nuisance side effects and possible gaps in therapeutic protection. The Modern Approach to the Treatment of Hypertension (MATH) trial was conducted to determine the efficacy and safety of the new once-daily nifedipine gastrointestinal therapeutic system (GITS) formulation in a large cohort of mild-to-moderate hypertensive patients overall, and to identify specific effects of therapy in the presence of complicating factors such as diabetes and obesity. A total of 1155 patients from 127 centers were treated with nifedipine GITS in the MATH trial, including 157 diabetic (fasting plasma glucose greater than 120 mg/dL or on hypoglycemic therapy) and 747 nondiabetic patients. There were 458 obese patients (body mass index [BMI] greater than 30), 489 overweight patients (BMI greater than or equal to 25 less than or equal to 30), and 206 patients of normal weight (BMI less than 25).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[General pharmacological action of tritoqualine (TRQ; (+/-)-(R*)-7-amino-4, 5, 6-triethoxy-3-[(R*)-5, 6, 7, 8-tetrahydro-4-methoxy-6-methyl-1, 3-dioxolo [4, 5-g] isoquinolin-5-yl] phthalide].

The general pharmacological action of TRQ was investigated, and the following results were obtained: With regard to its influence on the central nervous system, TRQ moderately potentiated the actions of hexobarbital (sleeping time) and methamphetamine (stereotyped behavior) at doses above 100 mg/kg, p.o. TRQ, however, had little influence on behavioral changes, EEG and motor function. TRQ only had slight influence on the respiratory and cardiovascular system at doses ranging from 0.1 to 3 mg/kg, i.v. Significant decrease in SBP and increases of HR, FAF and respiratory rate were observed after high doses (10-30 mg/kg, i.v.) of TRQ. TRQ also had little influence on contractility and pacemaker in isolated hearts, but moderately increased the coronary flow. The inhibitory effect of TRQ on the isolated smooth muscle was observed at high concentration and was non-specific. Furthermore, TRQ exhibited little influence on the autonomic nervous system. Among the effects of TRQ on the gastrointestinal system, it was shown that TRQ moderately increased the outflow of bile after doses above 1 mg/kg, i.v. TRQ also showed no remarkable actions on other aspects of the gastrointestinal system and blood coagulation system. Considering the present results, it may be suggested that there should be no serious problems in the application of TRQ as a hepatoprotective agent.

Animals↗
PubMed2003

Evaluation and treatment of autonomic disorders of the gastrointestinal tract.

Despite the extensive impact of autonomic function on the gastrointestinal system, there is little understanding of the mechanisms by which specific autonomic abnormalities translate into particular gastrointestinal complaints. Three logical alternatives include: (1) the underlying disorder affects the autonomic and gastrointestinal systems independently; (2) autonomic dysfunction alters gastrointestinal processing directly; (3) gastrointestinal manifestations arise as a delayed, indirect consequence of autonomic dysfunction. The major gastrointestinal manifestations of dysautonomia include esophageal dysmotility such as achalasia, gastroparesis, and small bowel bacterial overgrowth in the upper tract. Lower tract disorders include diarrhea, fecal incontinence, and constipation. Sorting through the varied causes of these disorders requires a careful history and examination in each patient. Supportive diagnostic studies may include radionuclide imaging, motility examination, and electrogastrography. Autonomic studies can (1) distinguish a purely enteric from a more generalized dysautonomia; (2) provide surrogate information about motility; (3) differentiate primary (e.g., multiple system atrophy) from secondary (e.g., irritable bowel syndrome) dysautonomias as the etiology of gastrointestinal symptoms. Several new strategies are available for the treatment of gastroparesis, constipation, irritable bowel, and sphincteric incontinence.

Animals↗
PubMed1989

Gastrointestinal events in patients prescribed non-steroidal anti-inflammatory drugs: a controlled study using record linkage in Tayside.

The relationship between non-steroidal anti-inflammatory drugs (NSAIDs) and gastrointestinal events has been examined in Tayside by record linkage. From March to October 1983, 57 715 prescriptions for five NSAIDs (ibuprofen, indomethacin, naproxen, Osmosin and piroxicam) were issued to 25 959 patients. Their inpatient morbidity from 1 January 1983 to 31 December 1985 was compared to that of an equal number of control subjects matched for age, sex and general practitioner. Analysis revealed that NSAID takers were more likely to develop disease of the gastrointestinal system (ICD 520-579) and symptoms involving the gastrointestinal system (ICD 787). For females the relative risk was 1.67 and for males 1.28. The difference between NSAID takers and controls increased with age above 60 years and was more pronounced over 70 years. Perforation and haemorrhage of peptic ulcer and gastrointestinal haemorrhage was also higher among NSAID takers after prescription: this difference was dependent upon age but not related to sex. The morbidity of the two groups, control and subsequent NSAID takers, was comparable before the NSAID prescriptions were issued and the control rates remained constant throughout the study.

Age Factors↗
PubMed2004

Simultaneous absence of dopamine D1 and D2 receptor-mediated signaling is lethal in mice.

Dopamine (DA) controls a wide variety of physiological functions in the central nervous system as well as in the neuroendocrine and gastrointestinal systems. DA signaling is mediated by five cloned receptors named D1-D5. Knockout mouse models for the five receptors have been generated, and, albeit impaired for some important DA-mediated functions, they are viable and can reproduce. D1 and D2 receptors are the most abundant and widely expressed DA receptors. Cooperative/synergistic effects mediated by these receptors have been suggested, in particular, in the control of motor behaviors. To analyze the extent of such interrelationship, we have generated double D1/D2 receptor mutants. Interestingly, in contrast to single knockouts, we found that concurrent ablation of the D1 and D2 receptors is lethal during the second or third week after birth. This dramatic phenotype is likely to be related to altered feeding behavior and dysfunction of the gastrointestinal system, especially because major anatomical changes were not identified in the brain. Similarly, in the absence of functional D1, heterozygous D2 mutants (D1r(-/-);D2r(+/-)) showed severe growth retardation and did not survive their postweaning period. The analysis of motor behavior in D1r/D2r compound mutants showed that loss of D2-mediated functions reduces motor abilities, whereas the effect of D1r ablation on locomotion strongly depends on the experimental paradigms used. These studies highlight the interrelationship between D1 and D2 receptor-mediated control of motor activity, food intake, and gastrointestinal functions, which has been elusive in the single-gene ablation studies.

Animals↗
PubMed1998

Problems arising from eastern and western classification systems for gastrointestinal dysplasia and carcinoma: are they resolvable?

It has become increasingly apparent that the Japanese and Western systems of classifying dysplasia and carcinoma in the gastrointestinal tract are not the same. The implication of these differences is that in an article in a Western journal on gastrointestinal 'cancer' originating from Japan, it is often impossible to repeat the study to confirm or refute it, because of these differences in definitions. Although there is no reason why it should not be just as much of a problem if Western research is published in Japanese journals, this is currently not a major problem. The terminological differences do not mean that one is right and one wrong; they are simply different. We had an opportunity to look at these differences in detail in a series of 100 gastric biopsies. In this review, we outline these differences and indicate the similarities, differences and problems between these two systems. 'Carcinoma' is diagnosed in Japan by virtue of its structural and cytological features, but by invasion in the Western system. Adenoma does not mean a dysplastic lesion in the Japanese system (although it can) but in most cases is similar to low-grade dysplasia irrespective of the macroscopic/endoscopic appearances (hence flat and depressed adenomas in the Japanese system); however, most examples of high-grade dysplasia in the Western system, as well as some low-grade dysplasia, becomes 'cancer' in the Japanese system. Conversely, both have conceptual areas that are useful in the other's systems. Because we were ultimately able to use each other's systems, we were able to show where these systems come together and diverge. These provide hope that a common classification encompassing both systems that allows communication between both systems is feasible.

Europe↗
PubMed1990

Acute toxicity from oral ingestion of crack cocaine: a report of four cases.

We report the symptomatology, clinical, and laboratory findings in four patients following oral ingestion of crack cocaine. All of the patients had a positive urine test for cocaine metabolites measured by gas chromatography-mass spectroscopy. Retrospective analysis of the four patients revealed alterations in function of the cardiovascular system (4), the autonomic nervous system (4), the central nervous system (3), and the gastrointestinal system (1). Three patients ingested crack cocaine as a direct result of confrontation with law enforcement officers. The symptomatologies of acute toxicity from oral ingestion of crack cocaine are related to its effect on the cardiovascular system and the brain. Cocaine toxicity should be considered in patients with acute and unexplained cardiovascular, central nervous system, or gastrointestinal complaints. Law enforcement personnel should be made aware of the signs and symptoms of cocaine intoxication and be made aware of the propensity to ingest the evidence.

Acute Disease↗