Sample records for antacids

  1. [Evaluation of antacids "in vitro"]. (United States)

    Alvarez de Saldaña, S; de Ramírez, A F; Ramírez Mata, M


    Five different antacids were compared "in vitro" through titration with NaOH 0.5 N to observe their neutralising power towards HCl 1.0 N. Eight pH measurements were done for each antacid. The neutralising capacity of the antacid was calculated with a specific formula for each pH measure reading, with this information statistical calculation were made to compare the antacids among themselves, with suggest that the method can be useful in the valuation of newly produced antacid before their clinical application.

  2. Counteractive effect of antacid suspensions on intrinsic dental erosion. (United States)

    Turssi, Cecilia P; Vianna, Lídia M F F; Hara, Anderson T; do Amaral, Flávia L B; França, Fabiana M G; Basting, Roberta T


    This in vitro study aimed to investigate the anti-erosive effect of antacid suspensions applied to enamel after exposure to hydrochloric acid (HCl). Ninety bovine enamel slabs were embedded, flattened, and polished. Reference areas were created and specimens were divided into six groups. They were exposed to 0.01 M HCl (pH 2) for 2 min, followed by immersion for 1 min in one of the following test suspensions: magnesium hydroxide, aluminum hydroxide, magnesium hydroxide/aluminum hydroxide, sodium alginate/sodium bicarbonate/calcium carbonate, or hydrated magnesium aluminate. Artificial saliva was used as a negative control. Specimens were subjected to a total of five cycles of erosion/antacid treatment. Enamel surface loss was measured (in micrometers) by optical profilometry. In addition, baseline and final surface microhardness (SMH) values of enamel were obtained. It was found that antacid suspensions significantly reduced enamel loss, and that similar protection was afforded by all formulations. No differences were observed between the final enamel SMH values among groups. Antacid suspensions counteracted HCl-induced enamel loss, although they were not effective in reducing enamel softening. Mouth rinsing with antacid suspensions after vomiting can potentially represent a promising strategy to counteract enamel loss caused by erosion.

  3. Use of antacids, alginates and proton pump inhibitors

    DEFF Research Database (Denmark)

    Lødrup, Anders; Reimer, Christine; Bytzer, Peter


    OBJECTIVE: Both over-the-counter medicine, such as antacids or alginates, and proton pump inhibitors (PPI) are used for treating acid-related disorders. We sought to describe what characterizes users of these different medicines, including long-term PPI users within the general population. METHOD...

  4. Interaction of roxatidine acetate with antacids, food and other drugs. (United States)

    Labs, R A


    The inhibition of hepatic mixed-function oxidase microsomal enzymes by cimetidine can lead to clinically important drug interactions. The metabolism of antipyrine is used as an index of hepatic enzymatic activity. The pharmacokinetic profiles of salivary antipyrine obtained following treatment with roxatidine acetate 75 mg or placebo twice a day for 7 days showed similar characteristics with no difference in the areas under the plasma concentration-time curves. In addition, roxatidine acetate 75 mg daily did not modify the clearance of propranolol, diazepam, desmethyldiazepam or controlled release theophylline preparations. Furthermore, there was no interference in the bioavailability of roxatidine acetate 150 mg daily when administered alone or in combination with a meal or antacids.

  5. Carbonated hydrocalumite synthesized by the microwave method as a possible antacid. (United States)

    Linares, Carlos F; Moscosso, Joel; Alzurutt, Victor; Ocanto, Freddy; Bretto, Pablo; González, Gema


    A carbonated hydrocalumite was synthesized by the microwave method for being used as antacid. The gel was formed using Ca and Al nitrate solutions in a basic medium (NaOH+Na2CO3), then, this gel was aged and heated in a domestic microwave for 2.5 min (1250 W). The obtained white solid was washed with distilled water, dried in an oven at 100 °C for 18 h and characterized by different techniques such as: X-ray diffraction (XRD), Fourier transformed infrared spectroscopy (FT-IR), BET surface area measurements, scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). Finally, the carbonated hydrocalumite was tested as antacid by using a synthetic gastric juice and its activity was compared with a commercial antacid formulated with hydrotalcite. Results showed that the carbonated hydrocalumite was more effective than that commercial antacid.

  6. 抗酸药研究进展%Development of the study on antacids

    Institute of Scientific and Technical Information of China (English)

    杨波; 王国清


    The traditional medicines and new-type antacids-complexes ofaluminum and magnesium are reviewed. The new-type antacids have sustained even antacid property and definite therapeutic effectiveness in the treatment of peptic ulcer diseases. These are new-type antacids deserved to be developed.%综述了传统抗酸剂与一类铝镁复合物新型抗酸剂。指出新型抗酸剂具有温和、持久的抗酸性能,在消化溃疡的治疗中疗效确切,不良反应小,是一种值得研究开发的新型抗酸药。

  7. Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin.


    Frost, R W; Lasseter, K C; Noe, A J; Shamblen, E C; Lettieri, J T


    This study was designed to determine the effects of an aluminum hydroxide antacid and a calcium carbonate antacid on the bioavailability of ciprofloxacin (Cipro). Cipro (750 mg) was administered orally to 12 healthy volunteers in a three-way randomized crossover design. The three treatments included Cipro alone, four 850-mg calcium carbonate tablets taken 5 min before Cipro, and three 600-mg aluminum hydroxide tablets taken 5 min before Cipro. The relative bioavailability of Cipro when given ...

  8. Relationship between treatment with antacid medication and the prevalence of food allergy in children. (United States)

    DeMuth, Karen; Stecenko, Arlene; Sullivan, Kevin; Fitzpatrick, Anne


    Food allergy affects 8% of preschool children, but factors responsible for food allergy in children are poorly understood. Use of antacid medication may be a contributing factor. The purpose of this study was to determine if parent-reported antacid medication use was associated with higher prevalence of food allergy in atopic children. In this cross-sectional study, parents of children with atopic diseases completed a questionnaire relating to a history of treatment with antacid medication and food allergy. Charts were independently reviewed for food-specific IgE and/or skin-prick test results. Food allergy was defined as a reaction to a food consistent with the anaphylaxis consensus statement and either an elevated food-specific IgE or a positive food skin-prick test. One hundred four questionnaires were completed. Mean age of the participating children was 7.0 ± 4.3 years (range, 5 months to 18 years of age). Forty-seven (45%) individuals were reported to have taken an antacid medication in the past. History of taking antacid medication was associated with an increased prevalence (57% (27)/47 versus 32% (18)/57) and higher prevalence of food allergy of having food allergy (aPR, 1.7 [1.1-2.5]). Mean peanut food-specific IgE was higher in those with a history of taking antacid medication (11.0 ± 5.0 versus 2.0 ± 5.5.; p = 0.01). History of treatment with antacid medication is associated with an increased prevalence of having food allergy.

  9. Study of as-synthesized and calcined hydrocalumites as possible antacid agents

    Indian Academy of Sciences (India)

    Carlos F Linares; Freddy Ocanto; Pablo Bretto; Maricela Monsalve


    A hydrocalumite-type solid was synthesized by the homogeneous co-precipitation method by using Ca and Al nitrate solutions in a basic medium (NaOH). This solid was calcined at 700 and 900 °C, respectively. Then, solids were characterized by X-ray diffraction, FT–IR spectroscopy and BET surface area measurements. Finally, these solids were tested as antacids by using a synthetic gastric juice. Results showed that calcined samples were able to neutralize the synthetic gastric juice in more extension as an as-synthesized hydrocalumite; however, the last solid showed better conditions as a potential antacid.

  10. Gastric cytoprotection beyond prostaglandins: cellular and molecular mechanisms of gastroprotective and ulcer healing actions of antacids. (United States)

    Tarnawski, Andrzej; Ahluwalia, Amrita; Jones, Michael K


    This article updates current views on gastric mucosal defense, injury, protection and ulcer healing with a focus on mucosal protective and ulcer healing actions of antacids. The gastric mucosa is continuously exposed to a variety of noxious factors, both endogenous such as: 0.1N hydrochloric acid, pepsin, bile acids, lysolecithin, H. pylori toxins and exogenous such as NSAIDs, ethanol and others. Gastric mucosal integrity is maintained by pre-epithelial, epithelial and post-epithelial defense mechanisms permitting the mucosa to withstand exposure to the above damaging factors. When mucosal defense is weakened or overwhelmed by injurious factors, injury develops in the form of erosions or ulcers. In the late 1970s Andre Robert and coworkers discovered that microgram amounts of a prostaglandin E2 analog protects the gastric mucosa against a variety of ulcerogenic and necrotizing agents - even such strong inducers of injury as 100% ethanol and boiling water. They proposed a new concept of cytoprotection. Subsequently, other compounds, such as sulfhydryls, sucralfate and epidermal growth factor were shown to exert protective action on gastric mucosa. Additionally, some antacids have been shown to exert a potent mucosal protective action against a variety of injurious factors and accelerate healing of erosions and gastric ulcers. These actions of antacids, especially hydrotalcite - the newest and the most extensively studied antacid - are due to activation of prostaglandin synthesis; binding to and inactivation of pepsin, bile acids and H. pylori toxins; induction of heat shock proteins; and, activation of genes encoding growth factors and their receptors.

  11. Carboxyterfenadine antacid interaction monitoring by UV spectrophotometry and RP-HPLC techniques

    Directory of Open Access Journals (Sweden)

    Hina Shehnaz


    Full Text Available Carboxyterfenadine, a primary metabolite of terfenadine, a second generation antihistaminic compound was introduced in therapy as a successor of terfenadine due to its cardiac arrhythmia. There are number of drug interactions of fexofenadine with erythromycin, ketoconazole and alike reported in the literature. In this paper, fexofenadine antacid interaction has been studied in presence of sodium bicarbonate, megaldrate, calcium carbonate, magnesium carbonate, aluminum hydroxide, magnesium hydroxide, magnesium trisilicate, simethicone (dimethylpolysiloxane and calcium hydroxide by UV–Vis spectrophotometer and high performance liquid chromatography (HPLC. These in vitro fexofenadine–antacid interactions were carried out in simulated gastric and intestinal juices and in buffer of pH 7.4 (simulating blood pH on BP 2005 dissolution apparatus. The results show non-concordant availability of fexofenadine envisaged due to formation of unstable charge transfer complexes.

  12. Evaluation of Antacid Activity of Microemulsion Formulation of Blend of Essential Oil

    Directory of Open Access Journals (Sweden)

    Joydeep Mazumder


    Full Text Available Essential oils are having wide range of biological activity is used to achieve therapeutic effects. These are volatile substances sensitive to oxygen, light, moisture and heat. In the present study microemulsion formulation was prepared using a blend of essential oil contains cardamom, coriander, fennel, caraway, ajowan and peppermint oil, water and non ionic surfactant tween 20 and cosurfactant as ethanol. Each essential oil was extracted from dried seed by steam distillation and characterized by Headspace Gas chromatography use of a marker compound which was linalool for coriander oil, cineol for cardamom oil, anethol for fennel oil, carvone for caraway oil, thymol for ajowan oil and menthol for peppermint oil. The marker compound was characterized using mass spectroscopy. Microemulsion of oil showed higher stability with droplet size in the range of 110-410nm. The product then screened for in vitro antacid properties which showed significant positive response.

  13. Omeprazole/Antacid-powder suspension-Santarus: omeprazole/sodium bicarbonate powder-Santarus, SAN 05. (United States)


    Santarus Inc. is developing an immediate-release formulation of omeprazole in combination with an antacid (sodium bicarbonate) as a powder for suspension, known as Acitreltrade mark [SAN 05] and also as Rapinex powder for oral suspension. This omeprazole powder suspension will be used to treat gastrointestinal haemorrhage, gastro-oesophageal reflux disease, heartburn and peptic ulcers. Acitreltrade mark is based on technology licensed from the University of Missouri. Santarus have also licensed technology from Tulane and North Carolina Universities relating to potential treatments for gastrointestinal (GI) diseases. Santarus has licensed exclusive, worldwide rights to patent applications covering specific combination formulations of proton pump inhibitors (PPIs) and antacids for treating various upper GI diseases and disorders. Santarus plans to license the development, distribution and marketing rights of omeprazole powder for oral suspension 20 mg outside the US, to one or more well established pharmaceutical companies. The US FDA has requested that Santarus pursue a name other than Rapinex for the product. Santarus is currently discussing potential alternative names for the product with the FDA. Santarus announced positive results in August 2003 from a phase III trial comparing oral Acitrel (Rapinex 40 mg) with intravenous cimetidine in preventing upper GI bleeding in 359 critically ill adult patients. Santarus has also completed an open-label clinical trial in 243 patients, including 97 patients with gastric ulcers, evaluating the safety of this omeprazole 40 mg powder suspension for an 8-week period. In connection with the NDA for omeprazole powder suspension 40 mg, Santarus provided notice to the NDA holder for Prilosec delayed-release capsules and related patent owners that omeprazole powder suspension 40 mg does not infringe currently listed patents for Prilosec or that those patents are invalid.

  14. Omeprazole/antacid-powder suspension--Santarus: Acitrel, Rapinex Powder for oral suspension, SAN 05. (United States)


    Santarus Inc., is developing an immediate-release formulation of omeprazole in combination with an antacid (sodium bicarbonate) as a powder for suspension, known as Acitrel [SAN 05], and also as Rapinex powder for oral suspension. Acitrel is based on technology licensed from the University of Missouri. Santarus have also licensed technology from Tulane and North Carolina Universities relating to potential treatments for GI diseases. Santarus have licensed exclusive, worldwide rights to patent applications covering specific combination-formulations of proton pump inhibitors and antacids for treating various upper GI diseases and disorders. Santarus plans to license development, distribution and marketing rights of Rapinex Powder for oral suspension 20mg outside the US, to one or more well established pharmaceutical companies. The US FDA has requested that Santarus pursue a name other than Rapinex for the product. Santarus is currently discussing potential alternative names for the product with the FDA. Santarus announced positive results, in August 2003, from a phase III trial comparing oral Acitrel (Rapinex 40mg) to intravenous cimetidine in preventing upper GI bleeding in 359 critically ill adult patients. Santarus has also completed an open-label clinical trial in 243 patients, including 97 patients with gastric ulcers, evaluating the safety of Rapinex 40mg for an 8-week period. In connection with the NDA for Rapinex 40mg, Santarus provided notice to the NDA holder for Prilosec delayed-release capsules and related patent owners that Rapinex 40mg does not infringe currently listed patents for Prilosec or that those patents are invalid.

  15. The neutralizing capacity and sodium content of antacid brands on the Kenyan market. (United States)

    Kibwage, I O; Machine, A; Hagos, B; Hoogmartens, J


    Seventeen brands of antacid products available on the Kenya market were investigated for their acid neutralising capacity and sodium content. Thirteen tablet products gave neutralising capacity per tablet of between 4.7 to 14.12 mMol hydrochloric acid. The neutralising capacities for the suspensions ranged between 11.97 to 34.32 mMol hydrochloric acid for 10ml suspension. The lowest neutralising capacities were obtained for products based on compound magnesium trisilicate and higher capacities for those containing magaldrate, or magnesium hydroxide or magnesium carbonate in combination with other ingredients. The fastest rate of neutralization was obtained with preparations containing carbonates and the lowest by compound magnesium trisilicate. The sodium content for the preparations was between < 0.001 mEq to 0.732 mEq sodium per minimum recommended dose. The study shows a high degree of variation in both the acid neutralising capacities and the sodium content of the different brands investigated.

  16. Rheological investigation of the shear strength, durability, and recovery of alginate rafts formed by antacid medication in varying pH environments. (United States)

    Elliott, Brooke M; Steckbeck, Kathleen E; Murray, Lisa R; Erk, Kendra A


    The mechanical response of alginate rafts formed by mixing liquid alginate antacid medication (Gaviscon Extra Strength Liquid Antacid) with acidic solutions was investigated by deforming isolated rafts in a shear rheometer. As rafts were deformed to varying magnitudes of applied strain, rheological parameters were identified and related to the overall strength, durability, and recoverability of rafts formed at different pH (1.1-1.7) and aging conditions (0.5-4 h). Rafts formed in the lowest acidity solutions (pH 1.4, 1.7) were elastically weak ( G'₀ = 60 , 42 Pa for un-aged raft) yet maintained their elasticity during applied shear deformation to large values of strain (γc∼90%, 50%, where G'≈G″), and displayed a low-to-moderate level of elastic recovery following large-strain deformation. Rafts formed in the highest acidity solution had the greatest strength ( G'₀ = 500 Pa for un-aged raft and 21.5 kPa for rafts after 0.5 h of aging), reduced durability (γc∼2.5%, independent of aging), and displayed the greatest recoverability. A trade-off existed between un-aged raft strength and durability while recovery was dependent on durability, solution pH, and age. Rheometry-based evaluations of alginate rafts could be used for the informed design of future gastric retention and antacid products.

  17. Efficacy of alginate-based reflux suppressant and magnesium-aluminium antacid gel for treatment of heartburn in pregnancy: a randomized double-blind controlled trial (United States)

    Meteerattanapipat, Pontip; Phupong, Vorapong


    The aim of this study was to compare the therapeutic efficacy of alginate-based reflux suppressant and magnesium-aluminium antacid gel for treatment of heartburn in pregnancy. A double-blinded, randomized, controlled trial was conducted. One hundred pregnant women at less than 36 weeks gestation with heartburn at least twice per week were randomized to either alginate-based reflux suppressant or to magnesium-aluminium antacid gel. Details of heartburn were recorded before beginning the treatment and the second week of study. Primary outcome measure was the improvement of heartburn frequency after treatment and secondary outcome were the improvement of heartburn intensity, quality of life, maternal satisfaction, maternal side effects, pregnancy and neonatal outcomes. There was no difference between treatment and control groups in improvement of heartburn frequency (80% vs 88%, p = 0.275), 50% reduction of frequency of heartburn (56% vs 52%, p = 0.688), improvement of heartburn intensity (92% vs 92%, p = 1.000) and 50% reduction of heartburn intensity (68% vs 80% cases, p = 0.075). There were also no significant differences in quality of life, maternal satisfaction, maternal side effects, pregnancy and neonatal outcomes. Alginate-based reflux suppressant was not different from magnesium-aluminium antacid gel in the treatment of heartburn in pregnancy. PMID:28317885

  18. Assessment of in vitro Antacid Activity of Different Root Extracts of Tephrosia purpurea (L) Pers by Modified Artificial Stomach Model

    Institute of Scientific and Technical Information of China (English)

    Sandhya S; Venkata Ramana K; Vinod K R; Chaitanya Rsnakk


    Objective: The purpose of the present investigation is to rule out the antacid activity of Tephrosiapurpurea root by in vitro method using a self fabricated and modified artificial stomach model. The reason for selecting in vitro method was to minimize the usage of experimental animals. Method:In this work we have used air bubbles from an aerator to mimic the peristaltic movements of stomach. Sodium bicarbonate and water were used as reference and control respectively. The parameters evaluated were neutralizing effect, duration of neutralization effect and capacity and effect of temperature on pH. We evaluated the potency of the plant by extracting with three solvents in increasing order of polarity. Results: The neutralization effect, duration of neutralization effect and capacity were found to be higher for methanol root extract than sodium bicarbonate, whereas ethyl acetate and chloroform extract produced moderately good response but less when compared to standard drug but higher than water. Conclusion: Hence this plant can be an effective alternative for sodium bicarbonate which is reported to have side effects like edema n the feet, alteration in systemic pH, belching etc.

  19. Antacid activity of calcium carbonate and hydrotalcite tablets. Comparison between in vitro evaluation using the "artificial stomach-duodenum" model and in vivo pH-metry in healthy volunteers. (United States)

    Vatier, J; Ramdani, A; Vitré, M T; Mignon, M


    Antacid activity of calcium carbonate (CAM, Rennie) and of hydrotalcite (HYD) containing tablets has been assessed in vitro using computer-controlled "artificial stomach-duodenum" model, including or not a piece of hog gastric mucosa in the gastric reservoir, and simulating the constant flux system or the normal gastroduodenal flux regulation. The data obtained under the latter condition were compared to those obtained in vivo by pH-metry in 12 healthy volunteers, in response to one administration of 2 tablets. The theoretical maximal capacity was similar when 1 tablet of CAM or of HYD was added to the gastric contents, including or not a piece of gastric mucosa, close to 95 H+ mmol. The reduction of acid load penetrating into the duodenum and the duodenal pH were of the same magnitude in response to both antacids. When normal gastroduodenal flux regulation was simulated, a dose-response curve, constructed by 1, 2 or 3 tablets, resulted in the same antacid characteristics in response to both antacids. The maximal gastric and the mean duodenal pH values obtained with CAM were, however, higher than with HYD, corresponding to a greater neutralizing activity developed by CAM than by HYD. The comparison between in vivo administration of two tablets of each antacid and the in vitro model simulating normal gastroduodenal flux regulation in response to the addition of two tablets resulted in similar data. The maximal pH values obtained in in vivo assays were slightly lower than in vitro, depending on the ratio of antacid amount to gastric acid content, well established in in vitro conditions and unknown in in vivo situations.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Effect of food, an antacid, and the H2 antagonist ranitidine on the absorption of BAY 59-7939 (rivaroxaban), an oral, direct factor Xa inhibitor, in healthy subjects. (United States)

    Kubitza, Dagmar; Becka, Michael; Zuehlsdorf, Michael; Mueck, Wolfgang


    To investigate the influence of food and administration of an antacid (aluminum-magnesium hydroxide) or ranitidine on the absorption of BAY 59-7939 (rivaroxaban), 4 randomized studies were performed in healthy male subjects. In 2 food interaction studies, subjects received BAY 59-7939, either as two 5-mg tablets (fasted and fed), four 5-mg tablets (fasted), or one 20-mg tablet (fasted and fed). In 2 drug interaction studies, BAY 59-7939 (six 5-mg tablets) was given alone or with ranitidine (150 mg twice daily, preceded by a 3-day pretreatment phase) or antacid (10 mL). Plasma samples were obtained to assess pharmacokinetic and pharmacodynamic parameters of BAY 59-7939. In the presence of food, time to maximum concentration (t(max)) was delayed by 1.25 hours; maximum concentration (C(max)) and area under the curve (AUC) were increased, with reduced interindividual variability at higher doses of BAY 59-7939. Compared with baseline, BAY 59-7939 resulted in a relative increase in maximum prothrombin time (PT) prolongation of 44% (10 mg) and 53% (20 mg) in the fasted state, compared with 53% and 83% after food. Time to maximum PT prolongation was delayed by 0.5 to 1.5 hours after food, with no relevant influence of food type. No significant difference in C(max) and AUC was observed with coadministration of BAY 59-7939 and ranitidine or antacid.

  1. Prospective, randomized, and active controlled study of the efficacy of alginic acid and antacid in the treatment of patients with endoscopy-negative reflux disease

    Institute of Scientific and Technical Information of China (English)

    I-Rue Lai; Ming-Shiang Wu; Jaw-Town Lin


    AIM: To assess the efficacy and safety of a compound containing alginic acid plus antacid (Topaal ) compared to equal-strength antacid (Nacid ) in patients with endoscopy-negative reflux disease (ENRD).METHODS: A total of 121 patients with ENRD were randomized to receive Topaal (65 patients) or Nacid (56patients) for 6 weeks, with a consultation every 3 weeks.The primary end-point assessment was the change in the severity of heartburn as evaluated using a visual analog scale (VAS) at 6 weeks. The secondary end-point assessments were the VAS at 3 weeks, the change of frequency of the reflux symptom, the change of quality of life and the adverse effects.RESULTS: Demographics of randomized subjects in each treatment group were comparable except that the Topaal group included more males. The baseline characteristics between the groups were similar. After 6weeks of treatment, the reduction of VAS of heartburn was more prominent in the Topaal group (-6.29 cm vs -4.11 cm). At the 3rd week, Topaal group showed greater reduction of VAS for heartburn (P=0.0016),regurgitation (P= 0.0006), vomiting (P= 0.0373), and belching (P<0.0001). The patients of the Topaal group had lower frequency of heartburn (P= 0.0015) and pain (P= 0.0163) at the end of the 6-week treatment period.From the doctor's point of view, the Topaal group also showed significant reduction in the severity of heartburn (P=0.0020), regurgitation (P=0.0081), vomiting (P= 0.0182), and belching (P= 0.0018) at the end of the treatment. The improvement of the quality of life was more remarkable in the Topaal group at the end of the 6-week treatment period (P< 0.0001). For the adverse effect, there was no difference in both the groups.CONCLUSION: Topaal is more effective than Nacid for the treatment of symptoms presented by patients with ENRD.

  2. Antacid activity of Laportea aestuans (L.) Chew

    DEFF Research Database (Denmark)

    Christensen, Charlotte Bremer; Soelberg, Jens; Jäger, Anna K


    to mimic the movements of the stomach. A titration was carried out with an artificial gastric acid to the end point of pH 3. The acid secretion rate was approximately 3mL and pH was monitored with a pH meter. Concentrations of 666 and 1332mg dried plant material were tested, both with and without addition...... of calcium carbonate (CaCO3). RESULTS: Both CaCO3 and L. aestuans had a significant better ability than water to neutralise an artificial stomach acid. 666mg plant material together with CaCO3 compared to CaCO3 alone showed approximately the same neutralisation time. When mixing 1332mg plant material with Ca...

  3. Non-ulcer dyspepsia associated with NSAID intake: possibility of antacid drugs application

    Directory of Open Access Journals (Sweden)

    A. E. Karateev


    Full Text Available Objective. To investigate the comparative efficacy of Magalphil 800 in NSAID-associated dyspepsia. Patients and methods. 30 pts with rheumatic diseases (RD receiving NSAIDs and having dyspeptic symptoms were included. Pts were divided into 2 groups: group 1 (n=20, 2 males, 18 females, mean age 51,7+12,3 yTs, 7 pts had single erosion of stomach, 1 - multiple erosions, 1 - ulcer of stomach; group 2 (n=10, 1 male. 9 females, mean age 46,2±14,6 yrs, 2 pts had single erosion of stomach. Concomitant therapies (corticosteroids, cytotoxics were approximately the same in both groups. Pts in Group 1 received one tablet of Magalphil 800 four times a day; pts in Group 2 were treated by ranitidine 150 mg bid. Therapy of RD was not changed during the study. Subjective complains were controlled after 2 weeks. Results. Complains related to dyspepsia disappeared in all pts of Group 1 and in 8 pts of Group 2 after 5,2±2,4 and 7,3±3,8 days of treatment respectively (p>0,05. Healing of ulcer in 1 and healing of erosions in 5 pnts was observed in Group 1. Conclusions. Magalphil 800 is effective in NSAID-associated dyspepsia and can be used for treatment of NSAID-induced gastropathy.

  4. Effect of food and various antacids on the absorption of tenoxicam. (United States)

    Day, R O; Lam, S; Paull, P; Wade, D


    1 Twelve healthy volunteers received a single oral dose of tenoxicam 20 mg on six occasions separated by 3 weeks. 2 The six occasions were: fasted overnight; postprandial; fasting and 15 ml aluminium hydroxide gel; postprandial and 15 ml aluminium hydroxide gel; fasting and 15 ml aluminium and magnesium hydroxide gel; postprandial and 15 ml aluminium and magnesium hydroxide gel. 3 Twenty plasma samples were collected over 15 days following dosing with tenoxicam. 4 The following kinetic parameters for plasma tenoxicam were compared: peak concentrations, time taken to reach peak concentrations, area under the plasma concentration-time curve (AUC) and half-life of elimination. 5 Food lengthened the time taken to reach peak tenoxicam concentrations (5.82 +/- 4.6 vs 1.84 +/- 1.0 h in the fasting state; P less than 0.02) and marginally reduced the peak concentrations achieved. AUC was not affected by any of the different regimens. 6 These effects of food on tenoxicam bioavailability are unlikely to be of clinical significance during chronic dosing with the drug. PMID:3499163

  5. Gastritis (United States)

    ... magnesium, aluminum, and calcium—along with hydroxide or bicarbonate ions to neutralize stomach acid. Antacids, however, can ... and prescription strengths. proton pump inhibitors (PPIs) include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), dexlansoprazole (Dexilant), pantoprazole (Protonix), ...

  6. Gemifloxacin (United States)

    ... are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums, others); didanosine (Videx); sucralfate (Carafate); or vitamin or mineral supplements that contain iron, magnesium, or zinc, take these medications 3 hours ...

  7. Parathyroid hormone (PTH) blood test (United States)

    ... excess calcium supplements or certain antacids, that contain calcium carbonate or sodium bicarbonate (baking soda) Parathyroid glands do ... More 25-hydroxy vitamin D test Bone tumor Calcium ... level Malabsorption Milk-alkali syndrome Multiple endocrine neoplasia (MEN) I Multiple ...

  8. A Laboratory Experiment on Combined Mass Transfer and Kinetics. (United States)

    Sanders, Stuart A.; Sommerfeld, Jude T.


    Follows the increase of the pH in a solution of vinegar during neutralization with commercial antacid tablets. Provided are background information, equipment details, procedures, and details of the data analysis. (MVL)

  9. Indigestion (United States)

    ... 2011:chap 139. Read More Abdominal bloating Belching Depression - overview Fiber Heart attack Nausea and vomiting - adults Stress and your health Patient Instructions Taking antacids Review Date 1/11/2015 Updated by: Todd Eisner, ...

  10. Absence of rebound effect with calcium carbonate. (United States)

    Simoneau, G


    This was an open, randomised balance cross-over study in 12 healthy male volunteers. The antacid activity of calcium carbonate plus magnesium carbonate (Rennie and hydrotalcite (Talcid), given in the recommended dose of 2 tablets 4 times daily, were compared using 24 h intragastric measurement of pH. The volunteers received 2 tablets of calcium carbonate plus magnesium carbonate or hydrotalcite according to a randomised order 1 h after each meal and at bedtime. Results showed that both treatments have similar antacid efficacy and a similar duration of action of about one hour. There was no evidence of acid 'rebound' following either treatment during the second and third hours following the administration of antacid.

  11. Longitudinal study of influence of Helicobacter pylori on current risk of duodenal ulcer relapse. The Hvidovre Ulcer Project Group

    DEFF Research Database (Denmark)

    Clausen, M R; Franzmann, M B; Holst, C;


    acid output, time of healing of the preceding ulcer, treatment of the present ulcer (cimetidine, antacids, or no treatment), or type and degree of gastritis. Thus, although H. pylori is prevalent in patients with duodenal ulcer disease, the present study indicates that H. pylori does not have...

  12. 21 CFR 331.80 - Professional labeling. (United States)


    .... (i) Prolonged use of aluminum-containing antacids in patients with renal failure may result in or... gastrointestinal tract and renal excretion of aluminum is impaired in renal failure. Aluminum is not well removed... aluminum are ingested orally by patients with impaired renal function. (ii) Aluminum forms...

  13. [Alginates in therapy for gastroesophageal reflux disease]. (United States)

    Avdeev, V G


    This article presents evidence of the prevalence of gastroesophageal reflux disease (GERD) and highlights its main treatment options. Among its medications, particular emphasis is laid on alginates and their main mechanisms of action are described. There is information on the efficacy of alginates, including the alginate-antacid Gaviscon Double Action, in treating GERD. Recommendations for how to administer these drugs are given.

  14. Drug: D04393 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D04393 Mixture, Drug Aluminum hydroxide, dried - magnesium hydroxide mixt; Aluminum... hydroxide - magnesium hydroxide mixt; Maalox (TN); Sakloft (TN) (Aluminum hydroxide, dried [DR:D02416] | Aluminum...r suspension: Aluminium hydroxide, dride Use of liquid: Aluminum hydroxide Therap... 234 Antacids 2349 Others D04393 Aluminum hydroxide, dried - magnesium hydroxide mixt PubChem: 17398090 ...

  15. Magnesium Oxide Induced Metabolic Alkalosis in Cattle


    Ogilvie, T H; Butler, D G; Gartley, C J; Dohoo, I. R.


    A study was designed to compare the metabolic alkalosis produced in cattle from the use of an antacid (magnesium oxide) and a saline cathartic (magnesium sulphate). Six, mature, normal cattle were treated orally with a magnesium oxide (MgO) product and one week later given a comparable cathartic dose of magnesium sulphate (MgSO4).


    NARCIS (Netherlands)



    The quinolone antibacterials are prone to many interactions with other drugs. Quinolone absorption is markedly reduced with antacids containing aluminium, magnesium and/or calcium and therapeutic failure may result. Other metallic ion-containing drugs, such as sucralfate, iron salts, and zinc salts,

  17. Calcium carbonate overdose (United States)

    Calcium carbonate is not very poisonous. Recovery is quite likely. But, long-term overuse is more serious than a single overdose, because it can cause kidney damage. Few people die from an antacid overdose. Keep all medicines in child-proof bottles and out ...

  18. Rifampin (United States)

    ... your medications or monitor you carefully for side effects.if you are taking antacids, take them at least 1 hour after you take rifampin.tell your doctor if you are taking or using hormonal contraceptives (birth control pills, patches, rings, implants, and injections). Rifampin can decrease ...

  19. Drug: D03238 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D03238 Drug Hydrotalcite (JAN/INN) Therapeutic category: 2343 ATC code: A02AD04 map07038 Antiulcer drugs The...ns 23 Digestive organ agents 234 Antacids 2343 Aluminum-containing agents D03238 Hydrotalcite (JAN/INN) Anatomical Therapeutic...rapeutic category of drugs in Japan [BR:br08301] 2 Agents affecting individual orga

  20. [Calcium suppletion for patients who use gastric acid inhibitors: calcium citrate or calcium carbonate?].

    NARCIS (Netherlands)

    Jonge, H.J. de; Gans, R.O.; Huls, G.A.


    Various calcium supplements are available for patients who have an indication for calcium suppletion. American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate ab

  1. Gastritis (United States)

    ... and stomach lining References Kuipers E, Blaser MJ. Acid peptic disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 141. Lee EL, Feldman M. Gastritis and gastropathies. In: Feldman ... Taking antacids Review Date 1/ ...

  2. Cimethidine pre-anesthetic. A prophylactic method against Mendelson's syndrome in cesarean section

    DEFF Research Database (Denmark)

    Qvist, N; Storm, K


    Twenty patients undergoing cesarean section received cimethidine 400 mg intramuscularly as pre-anesthetic approximately 70 minutes prior to gastric aspiration. The average pH was 5.05, as against 2.97 in the control group (p less than 0.01). No significant reduction in the aspirated volumes...... in the infants. Hence, cimethidine is a safe and useful pre-anesthetic for patients undergoing cesarean section, irrespective of indication and, consequently, much to be preferred to oral antacids....

  3. Intraoperative Gastric Suctioning and Postoperative Nausea, Retching, and Vomiting. (United States)


    than atropine ( Baraka , 1977; Salem, 1976). Antacids are used to decrease gastric acidity (Taylor, 1966) but at the same time add to gastric volume...aspiration. Placement of a gastric tube postoperatively is rarely indicated for the treatment of vomiting. The primary means of treatment for nausea...strength of the field experiment since the very realism of the setting often makes the findings more generalizable and meaningful .-.-. The greatest

  4. Iatrogenic Persistent Hypophosphatemia In A Simultaneous Liver-Kidney Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Ekamol Tantisattamo


    Although hyperphosphatemia is common in CKD, hypophosphatemia can occur from overzealous dietary restrictions and use of phosphate binders. Aluminum hydroxide is a potent phosphate binder commonly found in over the counter antacids. Ongoing review of medications (both prescription and over the counter is important to prevent hypophosphatemia. In addition, intestinal bypass, especially jejunal bypass, contributes to hypophosphatemia, and our case underscores the importance of the jejunum in phosphate absorption.

  5. A rare case of tuberculous meningitis with pancreatitis

    Directory of Open Access Journals (Sweden)

    Drishti Chandru Tolani


    Full Text Available Tuberculous meningitis (TBM is the most common form of central nervous system manifestation of tuberculosis. However, tuberculous pancreatitis is rarely reported. We present an 8-year-old female child with TBM who had intractable vomiting that persisted even after fever and meningeal signs had decreased after starting antituberculous therapy and did not respond to antacids. She was subsequently detected to have elevated serum amylase and lipase suggestive of pancreatitis. She responded to conservative management.

  6. SCI with Brain Injury: Bedside to Bench Modeling for Developing Treatment and Rehabilitation Strategies (United States)



  7. Renal Aspects of Peptic Ulcer Pharmacology

    Directory of Open Access Journals (Sweden)

    Daniel Muruve


    Full Text Available Medications to treat peptic ulcer disease are used widely and may have adverse effects on renal function. Similarly, renal dysfunction may alter the pharmacokinetics of this diverse group of medications resulting in dosage adjustments. The older agents, antacids and sucralfate, allow absorption of cations (calcium, magnesium and aluminum which may result in toxicity. Newer medications (H2 blockers and omeprazole appear to have fewer side effects and be better tolerated with appropriate dosage adjustments.

  8. Drug: D03309 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D03309 Drug Calcium silicate (NF) SiO4. 2Ca 171.8818 172.2391 D03309.gif Pharmaceut...] A ALIMENTARY TRACT AND METABOLISM A02 DRUGS FOR ACID RELATED DISORDERS A02A ANTACIDS A02AC Calcium compounds A02AC02 Calcium silica...te D03309 Calcium silicate (NF) CAS: 1344-95-2 PubChem:

  9. The association between aluminum-containing products and Alzheimer's disease. (United States)

    Graves, A B; White, E; Koepsell, T D; Reifler, B V; van Belle, G; Larson, E B


    The association between exposure to aluminum through the lifetime use of antiperspirants and antacids and Alzheimer's disease (AD) was explored in a case-control study of 130 matched pairs. Cases were clinically diagnosed between January 1980 and June 1985 at two geriatric psychiatric clinics in Seattle, Wash. Controls were friends or non-blood relatives of the case. Subjects were matched by age, sex, and the relationship between the case and his or her surrogate. For all antiperspirant/deodorant use, regardless of aluminum content, there was no association with AD (adjusted odds ratio (OR) = 1.2, 95% CI = 0.6-2.4). For aluminum-containing antiperspirants, the overall adjusted OR was 1.6 (95% CI = 1.04-2.4) with a trend toward a higher risk with increasing frequency of use (p for trend = 0.03), the adjusted OR in the highest tertile being 3.2. For antacids regardless of aluminum content, the overall adjusted OR was 3.1 (95% CI = 1.2-7.9). Here, a steep dose-response gradient was found (p for trend = 0.009), with an adjusted OR for the highest tertile of 11.7. However, when only aluminum-containing antacids were analyzed, the overall adjusted OR was only 0.7 (95% CI = 0.3-2.0) and there was no significant dose-response trend. These results are provocative but inconclusive due to methodologic problems relating to the necessary use of surrogate respondents and the long time period of potential exposure for this dementing disease.

  10. The Institute of Medicine, the Food and Drug Administration, and the calcium conundrum. (United States)

    Neupane, Shristi; Knohl, Stephen J


    In the present article we aim to bring forward the apparent disconnect between two US government-sponsored entities - the Institute of Medicine (IOM) and the Food and Drug Administration (FDA) - regarding the safe upper limit of Ca intake. In light of the 2011 US Congress-appointed IOM report indicating an upper limit of elemental Ca intake of 2000-2500 mg/d in adults (based on age group), it is perplexing that the FDA has not yet required a change on the labelling of over-the-counter Ca-containing antacids, some of which indicate an upper limit of elemental Ca intake of 2800-3000 mg/d. Even more concerning is that Ca intake is rarely from supplementation in isolation. National Health and Nutrition Examination Survey (NHANES) data from 2003-2006 indicate that mean dietary Ca intakes for males ranged from 871 to 1266 mg/d and for females from 748 to 968 mg/d depending on the age group. The estimated total Ca (diet + supplements) intake exceeded the upper limit in 5 % of the population older than 50 years. Furthermore, NHANES data from 1999-2000 indicate that when Ca is taken as part of an antacid preparation, patients often fail to report this as Ca intake. Thus, individuals taking the maximum allowable dose of supplemental Ca as antacids are at high risk for complications associated with excess Ca intake. Our hope is that by describing Ca homeostasis and highlighting the risks and dangers of Ca overload, the FDA will align its recommendation with the IOM and solve the current Ca conundrum in the USA for the sake of patient safety.

  11. Drug: D02416 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D02416 Drug Dried aluminum hydroxide gel (JP16); Dried aluminum hydroxide gel fine granules (JP16); Aluminum... hydroxide, dried (USP); Aluminum hydroxide (USP); ALterna GEL (TN); Dialume (TN) A...ffecting individual organs 23 Digestive organ agents 234 Antacids 2343 Aluminum-containing agents D02416 Dri...ed aluminum hydroxide gel (JP16); Dried aluminum hydroxide gel fine granules (JP16); Aluminum hydroxide, dried (USP); Aluminum...AB Aluminium compounds A02AB01 Aluminium hydroxide D02416 Aluminum hydroxide, dried (JP16/USP); Aluminum hyd

  12. Severe Symptomatic Hypermagnesemia Associated with Over-the-Counter Laxatives in a Patient with Renal Failure and Sigmoid Volvulus. (United States)

    Khairi, Talal; Amer, Syed; Spitalewitz, Samuel; Alasadi, Lutfi


    Hypermagnesemia is an uncommon but a potentially serious clinical condition. Over-the-counter magnesium containing products are widely used as antacids or laxatives. Although generally well tolerated in patients with normal renal function, their unsupervised use in the elderly can result in severe symptomatic hypermagnesemia, especially in those patients with concomitant renal failure and bowel disorders. We report a case of severe symptomatic hypermagnesemia associated with over-the-counter laxatives in a 70-year-old male patient with renal failure and sigmoid volvulus, who was successfully treated with hemodialysis.

  13. Severe Symptomatic Hypermagnesemia Associated with Over-the-Counter Laxatives in a Patient with Renal Failure and Sigmoid Volvulus

    Directory of Open Access Journals (Sweden)

    Talal Khairi


    Full Text Available Hypermagnesemia is an uncommon but a potentially serious clinical condition. Over-the-counter magnesium containing products are widely used as antacids or laxatives. Although generally well tolerated in patients with normal renal function, their unsupervised use in the elderly can result in severe symptomatic hypermagnesemia, especially in those patients with concomitant renal failure and bowel disorders. We report a case of severe symptomatic hypermagnesemia associated with over-the-counter laxatives in a 70-year-old male patient with renal failure and sigmoid volvulus, who was successfully treated with hemodialysis.

  14. Posaconazole tablet pharmacokinetics: lack of effect of concomitant medications altering gastric pH and gastric motility in healthy subjects. (United States)

    Kraft, Walter K; Chang, Peter S; van Iersel, Marlou L P S; Waskin, Hetty; Krishna, Gopal; Kersemaekers, Wendy M


    Posaconazole oral suspension is an extended-spectrum triazole that should be taken with food to maximize absorption. A new posaconazole tablet formulation has demonstrated improved bioavailability over the oral suspension in healthy adults in a fasting state. This study evaluated the effects of concomitant medications altering gastric pH (antacid, ranitidine, and esomeprazole) and gastric motility (metoclopramide) on the pharmacokinetics of posaconazole tablets. This was a prospective open-label 5-way crossover study in 20 healthy volunteers. In each treatment period, a single 400-mg dose (4 100-mg tablets) of posaconazole was administered alone or with 20 ml antacid (2 g of aluminum hydroxide and 2 g of magnesium hydroxide), ranitidine (150 mg), esomeprazole (40 mg), or metoclopramide (15 mg). There was a ≥ 10-day washout between treatment periods. Posaconazole exposure, time to maximum concentration of drug in serum (Tmax), and apparent terminal half-life (t1/2) were similar when posaconazole was administered alone or with medications affecting gastric pH and gastric motility. Geometric mean ratios (90% confidence intervals [CIs]) of the area under the concentration-time curve from time zero to infinity (AUC0-inf) (posaconazole with medications affecting gastric pH and gastric motility versus posaconazole alone) were 1.03 (0.88-1.20) with antacid, 0.97 (0.84-1.12) with ranitidine, 1.01 (0.87-1.17) with esomeprazole, and 0.93 (0.79-1.09) with metoclopramide. Geometric mean ratios (90% CIs) of the maximum concentration of drug in serum (Cmax) were 1.06 (0.90-1.26) with antacid, 1.04 (0.88-1.23) with ranitidine, 1.05 (0.89-1.24) with esomeprazole, and 0.86 (0.73-1.02) with metoclopramide. In summary, in healthy volunteers, the pharmacokinetics of a single 400-mg dose of posaconazole tablets was not altered to a clinically meaningful extent when posaconazole was administered alone or with medications affecting gastric pH or gastric motility.

  15. [Drug-induced oesophageal ulcers (author's transl)]. (United States)

    Kobler, E; Bühler, H; Nüesch, H J; Deyhle, P


    Within a one-year period seven patients were observed who had developed ulcers of the upper and mid oesophagus after treatment with doxycycline hydrochloride (n = 3), emepronium bromide (n = 3) or Pantogar (n = 1). In each instance the drug had apparently been swallowed dry. The typical symptoms were a sudden onset of retrosternal chest pain and odynophagia during bed rest. Once the drug had been discontinued and treatment with antacid combined with topical anaesthetics and/or alginic acid instituted the symptoms disappeared within a few days. The authors stress that drugs should be swallowed only with good amounts of fluid and generally not immediately before bed rest.

  16. Effects of oral rehydration therapy on gastric volume and pH in patients with preanesthetic H2 antagonist. (United States)

    Nakai, Kishiko; Niwa, Hidetomo; Kitayama, Masatou; Satoh, Yutaka; Hirota, Kazuyoshi


    Recent preanesthetic fasting practice allows patients to take clear fluids up to 2 h before surgery without taking any antacid for the prophylaxis of aspiration pneumonia; this practice is defined as oral rehydration therapy (ORT). It has been reported that with ORT the gastric volume may be significantly lower than that with a standard fasting regimen, although in a standard fasting regimen without preanesthetic antacid, gastric pH and volume values could be critical for causing aspiration pneumonia. In this study we compared gastric fluid status in patients with ORT and those with a standard fasting regimen; patients in both groups received a preanesthetic H(2) antagonist. One hundred and four patients were randomly assigned to either the ORT or standard fasting group, and all were given roxatidine 75 mg 2 h before surgery. After the induction of anesthesia, the gastric contents were collected via a gastric tube to measure gastric volume and pH. Neither gastric volume nor pH differed between the groups (ORT 9.6 ± 8.2 ml and 5.6 ± 1.7, respectively, vs. standard fasting 8.5 ± 6.8 ml and 5.5 ± 1.7, respectively). These data suggest that ORT may not reduce gastric volume in patients receiving a preanesthetic H(2) antagonist.

  17. Pharmacokinetics of 2',3'-dideoxyinosine in patients with severe human immunodeficiency infection. II. The effects of different oral formulations and the presence of other medications. (United States)

    Hartman, N R; Yarchoan, R; Pluda, J M; Thomas, R V; Wyvill, K M; Flora, K P; Broder, S; Johns, D G


    2',3'-Dideoxyinosine (ddI) has shown activity against human immunodeficiency virus in phase I clinical trials. The drug is rapidly degraded by acid, however, thus raising questions as to the efficiency and reproducibility of its absorption after oral administration. This investigation studies the bioavailability of several oral dosage forms of ddI. When ddI was given to fasting patients as an oral solution with antacid, the bioavailability was 41% +/- 7% (mean +/- SEM). However, when given as buffered tablets, the bioavailability was considerably less (25% +/- 5%). The bioavailability increased slightly when the tablets were given with supplemental antacid (36% +/- 6%). Two enteric-coated preparations had reasonable bioavailability (36% +/- 5% and 26% +/- 5%), but the peak plasma level was much lower and occurred at a much later time than with the oral solution. When ddI was given as a premeasured powder containing sucrose and buffer to be reconstituted by the patient (the "sachet" preparation), the bioavailability was 29% +/- 6%. This was similar to that of the oral solution for this particular group of patients (30% +/- 7%). However, the bioavailability of the sachet was only 17% +/- 4% when administered with food. When the sachet was given to patients receiving ranitidine, no consistent change in bioavailability was noted. Also, no change in ddI pharmacokinetics was noted in patients receiving ganciclovir.

  18. Hidróxidos duplos lamelares: síntese, estrutura, propriedades e aplicações

    Directory of Open Access Journals (Sweden)

    Crepaldi Eduardo Luis


    Full Text Available The layered double hydroxides, known as anionic clays and represented by the general formula [M2+1-x M3+x (OH 2]x+ Am-x/m·nH 2O, are a group of materials which are of much interest currently. They present a variety of potential applications as adsorbents, catalysts and catalyst support, ion-exchangers, antacids and as a polymer stabilizer. It is possible to obtain a broad variety of layered double hydroxides (LDHs, depending on the identity and ratio of the cations M2+ and M3+, as well as the interlamelar anion. The aim of this review is to give out some information about this class of materials, concerning to the synthesis, characterization, properties and applications.

  19. [A case of pseudomembranous colitis in a juvenile rheumatoid arthritis patient taking methotrexate]. (United States)

    Yu, Ji Han; Kim, Na Young; Lee, Hae Min; Lee, Ha Ni; Ahn, Hyo Jun; Kim, Sang Woo; Choi, Kyu Yong


    Pseudomembranous colitis is mainly caused by antibiotics and Clostridium difficile infection. But conditions such as gastrointestinal surgery, antacid medication, anti-neoplastic agent or immunosuppressive agent which influences the normal flora of colon can induce colitis without the administration of any antibiotics. We experienced a 13 year-old male who was taking low-dose methotrexate for juvenile rheumatoid arthritis complained diarrhea and abdominal pain for 3 weeks. Sigmoidoscopic findings revealed diffuse patch yellowish pseudomembranes on the rectum. Histologic finding was compatible to pseudomembranous colitis. His symptom was improved after stop taking methotrexate and the administration of metronidazole. If a patient treated with immunosuppressive agents or antineoplastic agents complains diarrhea, fever or abdominal pain and has not improved with conservative care, pseudomembranous colitis should be taken into account as a differential diagnosis and prompt treatment is required for better prognosis.

  20. Do Pregnant Women Report Use of Dispensed Medications?

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Søndergaard, Charlotte; Thrane, Nana;


    such as antihistamines, antibiotics, antacids, nonsteroid anti-inflammatory drugs, and gynecologic drugs. Thus, for the latter drug groups the prescription database may provide an incomplete identification of exposure. Neither data source is unbiased regarding actual drug intake. Nevertheless, our results indicate......Surveillance of drug safety in pregnancy often draws on administrative prescription registries. Noncompliance in the use of prescribed medication may be frequent among pregnant women owing to their fear of fetotoxic side effects. To estimate compliance in the use of prescription drugs dispensed...... during pregnancy, we compared prescription data from the North Jutland Prescription Database with information on drug use provided by pregnant women to the Danish National Birth Cohort (DNBC), which is a health interview survey. We used the North Jutland Prescription Database to identify all prescription...

  1. Successful tubes treatment of esophageal fistula

    Institute of Scientific and Technical Information of China (English)


    Aim: To discuss the merits of "tubes treatment" for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. Results:The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Conclusion: Tubes treatment is an effective basic way for EF. It may be an alternative treatment option.

  2. A comparison of roxatidine acetate 150 mg once daily and 75 mg twice daily in gastric ulcer healing. (United States)

    Rösch, W


    In 363 outpatients with endoscopically confirmed gastric ulcers the efficacy and safety of roxatidine acetate 150 mg at night was compared to 75 mg twice daily. After 8 weeks' treatment substantial reductions in gastric ulcer diameter were obtained in addition to healing rates of 83.7 and 86% for the twice daily and night-time dosing, respectively. Daily reductions in day and night-time epigastric pain were obtained with no significant differences between treatment groups for pain scores or antacid tablet consumption. Furthermore, cigarette smoking did not influence the healing rates produced by either treatment schedule. 26 patients reported 32 adverse reactions and 5 patients discontinued treatment because of side effects, although only 1 of these was a severe reaction. The present data suggest that a single night-time dose of roxatidine acetate 150 mg is as safe and effective as the twice daily dose regimen for the management of acute gastric ulceration.

  3. Silicate Urolithiasis during Long-Term Treatment with Zonisamide

    Directory of Open Access Journals (Sweden)

    Satoru Taguchi


    Full Text Available Silicate urinary calculi are rare in humans, with an incidence of 0.2% of all urinary calculi. Most cases were related to excess ingestion of silicate, typically by taking magnesium trisilicate as an antacid for peptic ulcers over a long period of time; however, there also existed unrelated cases, whose mechanism of development remains unclear. On the other hand, zonisamide, a newer antiepileptic drug, is one of the important causing agents of iatrogenic urinary stones in patients with epilepsy. The supposed mechanism is that zonisamide induces urine alkalinization and then promotes crystallization of urine components such as calcium phosphate by inhibition of carbonate dehydratase in renal tubular epithelial cells. Here, we report a case of silicate urolithiasis during long-term treatment with zonisamide without magnesium trisilicate intake and discuss the etiology of the disease by examining the silicate concentration in his urine.

  4. Analysis of risk factors for pneumonia in critically ill patients with stroke%重症脑卒中患者肺部感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    高晗清; 罗玉敏


    目的 探讨重症脑卒中患者肺部感染的发生率及其危险因素.方法 回顾性分析2010年10月~2012年5月入住神经内科重症监护室(NICU)的重症脑卒中患者148例,根据罹患肺部感染与否分为卒中相关性肺炎组与无卒中相关性肺炎组,分析重症脑卒中患者肺部感染的发生率及危险因素.结果 重症脑卒中患者中99例并发了卒中相关性肺炎,发生率为66.9%.重症脑卒中患者罹患肺部感染与格拉斯哥昏迷评分(GCS)<9分、鼻饲、抑酸药物的使用及机械通气密切相关.Logistic 回归分析显示,GCS<9分及抑酸药物的使用与卒中相关性肺炎独立相关.结论 GCS<9分、鼻饲、抑酸药物的使用及机械通气是重症脑卒中患者罹患肺部感染的危险因素,其中GCS<9分及使用抑酸药物是其独立危险因素.%Objective To determine the incidence and risk factors of pneumonia in critically ill patient with stroke. Methods Clinical data in critically ill patients with stroke who were admitted to NICU from October 2010 to May 2012 was collected retrospectively. All the patients were divided into pneumonia group (SAP group) and non-pneumonia group (no SAP group). The incidence and risk factors of pneumonia in critically ill patient with stroke were analyzed. Results Among critically ill patients with stroke, 99 patients met the study pneumonia criteria, the incidence of inpatients of neurological intensive care unit was 66.9%. Subjects who developed pneumonia had higher proportion in terms of GCS<9, nasal feeding, antacid drugs, and application of mechanical ventilation. Logistic regression analysis showed that GCS<9 and antacid drugs were the independent risk factors for stroke associated pheumonia. Conclusion Pneumonia in critically ill patient with stroke is associated with GCS<9, nasal feeding, antacid drugs, and application of mechanical ventilation. GCS<9 and antacid drugs are independent risk factors for pneumonia.

  5. [Therapeutic principles in gastroesophageal reflux]. (United States)

    Chassany, O; Elkharrat, D; Bergmann, J F; Segrestaa, J M


    Gastroesophageal reflux is a common disease. Its chronic course, even if mild, is sometimes complicated by erosive oesophagitis. Drug therapy acts against gastric acidity and motility disorders. Treatment of gastroesophageal reflux disease has three aims: improvement of symptoms and quality of life, healing erosive lesions and prevention of symptomatic and endoscopic relapses. Non-drug measures are always useful, even if their efficacy is not well established. Initial therapy of a symptomatic reflux or mild oesophagitis is most of the time effective (antacids, prokinetics, H2 receptor antagonists). Proton-pump inhibitors are also effective in healing and preventing severe oesophagitis. Questions about long-term treatment adverse events with powerful acid inhibitors, such as hypergastrinemia and the risk of gastric carcinoid tumours seem to be resolved. Studies are requested to define the optimal long-term maintenance treatment with cisapride, H2 receptor antagonists or proton-pump inhibitors at low doses in prevention of symptomatic and mild oesophagitis relapses.

  6. Cobalamin Deficiency in Elderly Patients: A Personal View

    Directory of Open Access Journals (Sweden)

    Emmanuel Andrès


    Full Text Available Cobalamin (vitamin B12 deficiency is particularly common in the elderly (>65 years of age but is often unrecognized because its clinical manifestations are subtle; however, they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. In the elderly, the main causes of cobalamin deficiency are pernicious anemia and food-cobalamin malabsorption. Food-cobalamin malabsorption syndrome is a disorder characterized by the inability to release cobalamin from food or its binding proteins. This syndrome is usually caused by atrophic gastritis, related or unrelated to Helicobacter pylori infection, and long-term ingestion of antacids and biguanides. Management of cobalamin deficiency with cobalamin injections is currently well documented but new routes of cobalamin administration (oral and nasal are being studied, especially oral cobalamin therapy for food-cobalamin malabsorption.

  7. [Mechanisms and risk factors for type 1 food allergies: the role of gastric digestion]. (United States)

    Diesner, Susanne C; Pali-Schöll, Isabella; Jensen-Jarolim, Erika; Untersmayr, Eva


    True food allergens are considered as digestion stable proteins, which are absorbed through the gastrointestinal epithelium in an intact form leading to sensitization and causing systemic symptoms. According to classifications, allergens, which are digestion-labile, cause local symptoms by their cross-reactivity towards inhalative allergens. Our recent studies revealed that digestion labile allergens can also have sensitizing capacity if gastric digestion is hindered. The increase of gastric pH via acid-suppression by proton pump inhibitors, sucralfate or antacids, interferes with protein digestion, and leads to sensitization and allergic reaction in mouse models as well as in human patients. Furthermore, the inhibition of digestion increases the risk for anaphylactic responses in sensitized individuals.Even though also other factors, such as sphingolipid metabolites, are associated with the development of food allergies, it is without any doubt that the stomach has an important gate keeping function against food allergies.

  8. Management of upper dyspepsia in general practice

    DEFF Research Database (Denmark)

    Kjeldsen, Hans Christian; Kier, Svend; Husum, Gitte;

    practitioner (GP) finds indication for treatment with antisecretory therapy and/or diagnostic Helicobacter Pylori test were included in general practice between June 2000 and June 2002.  Patients the GP want to refer to endoscopy were not included. Dyspepsia definition: persistent or recurrent pain...... of dyspepsia, dyspeptic episodes, main symptom, previous contact to general practice, previous gastroscopia, use of antacids or NSAID's, Helicobacter Pylori status and mental/physical well being (SF-36 measurement scale) (Table 1). After two weeks the GPs assessed 46 % of the patients to be free of symptoms......)   Conclusion In management of dyspepsia therapy does have a better short term effect than endoscopy concerning symptom relief, but after 3 months the endoscopy strategy had a better effect than PPI concerning symptom relief  ...


    Directory of Open Access Journals (Sweden)

    Lyubov Valeryevna Kondratyeva


    Patients with antiphospholipid (aPL antibodies and venous thromboses need long-term moderate-intensity warfarin therapy. Patients with ischemic strokes without other indications for the use of anticoagulants may be given either warfarin or ASA. In the latter case, there is no need for laboratory control or an individual dose adjustment. The primary prevention of thromboses in the presence of aPL is also performed with ASA. When pregnancy occurs, women with obstetric manifestations of APS may be given small-dose ASA in combination with heparins. To reduce the risk of hemorrhages, warfarin dosage adjustment is initiated with the minimum doses (<5 mg/day. Novel ASA formulations, such as ASA with the unabsorbed antacid magnesium hydroxide, have been developed to prevent gastrointestinal tract complications.

  10. Comparison of omeprazole with cimetidine for prophylaxis of acid aspiration in elective surgery. (United States)

    Bouly, A; Nathan, N; Feiss, P


    Gastric pH and volume were measured in four groups of 15 patients scheduled for elective surgery. The patients were randomly allocated to receive either no antacid, oral omeprazole 40 mg the evening before surgery, oral omeprazole 40 mg 2 h before surgery, or effervescent cimetidine 800 mg, 2 h before surgery. Anaesthesia was induced with thiopentone (4-6 mg kg-1), fentanyl (0.03 mg kg-1) and vecuronium (0.1 mg kg-1) and maintained with nitrous oxide in oxygen (50/50) and isoflurane. After induction of anaesthesia and on completion of surgery, gastric pH (mean +/- SEM) and volume were measured using a glass electrode and a phenol red dilution technique. Gastric pH were significantly higher in the three treated groups than in control (P 25 ml).

  11. [Guidelines of treatment for non-bleeding peptic ulcer disease]. (United States)

    Cheung, Dae Young; Jung, Hwoon Yong; Song, Ho June; Jung, Sung Woo; Jung, Hyun Chae


    Over the past century, since the introduction of non steroidal anti-inflammatory drugs (NSAID), antacid, histamine H2-receptor antagonists (H2RA), proton pump inhibitors (PPI), and discovery of Helicobacter pylori infection, the paradigm of peptic ulcer disease has changed with marked decrease in morbidity and mortality. However, peptic ulcer disease still occupies a position as a major health problem with increase of aged population and NSAIDs usage. In daily general practice, the management of peptic ulcer disease is directed according to the presence of bleeding or not. For non-bleeding peptic ulcer disease, proper acid suppression and the correction of underlying causes such as Helicobacter pylori infection and NSAID use is the main stay of treatment. Though a complete understanding of pathophysiology and a perfect treatment strategy are still a challenge, this guideline aims to provide practical recommendations based on evidences or consensus of experts through in-depth literature review and expert meeting.

  12. Non-prescription proton-pump inhibitors for self-treating frequent heartburn: the role of the Canadian pharmacist

    Directory of Open Access Journals (Sweden)

    Armstrong D


    Full Text Available Heartburn and acid regurgitation are the cardinal symptoms of gastroesophageal reflux and occur commonly in the Canadian population. Multiple non-prescription treatment options are available for managing these symptoms, including antacids, alginates, histamine-H2 receptor antagonists (H2RAs, and proton-pump inhibitors (PPIs. As a result, pharmacists are ideally positioned to recommend appropriate treatment options based upon an individual’s needs and presenting symptoms, prior treatment response, comorbid medical conditions, and other relevant factors. Individuals who experience mild heartburn and/or have symptoms that occur predictably in response to known precipitating factors can manage their symptoms by avoiding known triggers and using on-demand antacids and/or alginates or lower-dose non-prescription H2RAs (e.g. ranitidine 150 mg. For those with moderate symptoms, lifestyle changes, in conjunction with higher-dose non-prescription H2RAs, may be effective. However, for individuals with moderate-to-severe symptoms that occur frequently (i.e. ≥2 days/week, the non-prescription (Schedule II PPI omeprazole 20 mg should be considered. The pharmacist can provide important support by inquiring about the frequency and severity of symptoms, identifying an appropriate treatment option, and recognizing other potential causes of symptoms, as well as alarm features and atypical symptoms that would necessitate referral to a physician. After recommending an appropriate treatment, the pharmacist can provide instructions for its correct use. Additionally, the pharmacist should inquire about recurrences, respond to questions about adverse events, provide monitoring parameters, and counsel on when referral to a physician is warranted. Pharmacists are an essential resource for individuals experiencing heartburn; they play a crucial role in helping individuals make informed self-care decisions and educating them to ensure that therapy is used in an optimal

  13. Review article: immediate-release proton-pump inhibitor therapy--potential advantages. (United States)

    Howden, C W


    The absorption of most oral proton-pump inhibitors is delayed by the enteric coating required to protect the acid-labile proton-pump inhibitor from degradation in the stomach and, as a result, antisecretory effect is also delayed. This article provides an overview of the pharmacokinetics and pharmacodynamics of a new immediate-release omeprazole [(IR-OME) Zegerid power for oral suspension; Santarus Inc., San Diego, CA, USA] and its potential advantages over delayed-release proton-pump inhibitors. Immediate-release omeprazole has a higher mean peak plasma omeprazole concentration (C(max)) and a significantly shorter mean time to reach C(max) (t(max)) than delayed-release omeprazole. Immediate-release omeprazole 40 mg has a prolonged antisecretory effect with median intragastric pH above 4.0 for 18.6 h/day at steady-state, after 7 days of once daily dosing. The sodium bicarbonate in immediate-release omeprazole protects the uncoated omeprazole from degradation by gastric acid. The accelerated antisecretory action of immediate-release omeprazole compared with delayed-release omeprazole may be due to the activation of proton pumps by the rapid neutralization of intragastric acid by the sodium bicarbonate. The faster onset of action seen with immediate-release omeprazole is not achieved by using an antacid with a delayed-release proton-pump inhibitor, because administering antacids with conventional delayed-release proton-pump inhibitors does not significantly enhance absorption of the proton-pump inhibitor. In conclusion, immediate-release omeprazole is associated with rapid absorption of omeprazole and rapid onset of antisecretory effect, without compromising the duration of acid suppression.

  14. Does Ramadan Fasting Increase duodenal ulcer perforation?

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    Abdoulhossein Davoodabadi


    Full Text Available Introduction: In Ramadan, healthy adult Muslims are obliged to fast. Prolonged fasting increase gastric acid and pepsin levels, which promote the risk of duodenal ulcer perforation (DUP. Effects of Ramadan fasting on DUP have not been thoroughly studied yet, and the limited number of studies investigating the impact of Ramadan fasting on DUP yielded discrepant results. This study aimed to evaluate DUP frequency during Ramadan 2011-2015 and compare it with other months. Methods: This cross-sectional study was performed in 82 patients undergoing surgery due to DUP during July 2011-September 2015. The demographics, history of addiction, use of nonsteroidal and antiinflammatory drugs, previous history of acid peptic disease, as well as complications and outcomes of treatment were recorded and analyzed, and the obtained results were compared between Ramadan and other lunar months. Results: The majority of patients were male (86.6%, 71 patients, with a mean age of 43.9±16.5 years (age range: 20-75 years. Male to female ratio was 6:1. Cases with less than 30 years of age were less frequent (22%, 18 patients. DUP was more frequent during Rajab with nine cases (11%, while during Ramadan, six cases were reported, the difference between Ramadan and other months regarding the incidence of DUP was not significant (P=0.7. Risk factors such as smoking (60% and addiction (44%; especially to crystal and crack were noted. Consumption of nonsteroidal antiinflammatory drugs in 20 (24% patients, and use of antacids in 17 (25% patients. Distribution of DUP in different blood types was as follows: O+=41%, A+=28%, B+=23%, AB=5%, and O-=3%; moreover, post-operative Helicobacter pylori antibody was present in 67% of the patients. Conclusion: Ramadan fasting did not escalate DUP incidence, and those with DUP risk factors can fast with the use of antacids.

  15. Clinical analysis of ventilator-associated pneumonia

    Institute of Scientific and Technical Information of China (English)

    Bing-Qu Deng; Yong Liang


    Objective:To investigate the clinical analysis associated pneumonia in elderly ventilator. Methods:Through January 2011 to December 2013 in our hospital 165 cases of ventilator therapy in elderly patients with clinical data were retrospectively analyzed, discussed ventilator-associated pneumonia in the elderly risk factors, clinical symptoms, and the distribution of pathogens analysis of drug resistance.Results: The patient's age, sex, APACHE score, the incidence of aspiration, sedation and antacids, ventilator time were higher in patients (P<0.05); pathogens of ventilator-associated pneumonia in the elderly by high to low order of Pseudomonas aerations, Acinetobacter sop, etc.; pathogens commonly used in clinical antimicrobial drug resistance is higher.Conclusion:Take the risk factors associated pneumonia ventilator for elderly corresponding measures to reduce the incidence of ventilator-associated pneumonia, which Gram-negative bacteria as cause of ventilator-associated pneumonia in the elderly is an important pathogen occurs, the clinical course of treatment should be combined with a reasonable choice of antimicrobial susceptibility testing.

  16. Gastro-oesophageal Reflux Disease: An Update

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    T Murphy


    Full Text Available Gastro-oesophageal reflux disease (GERD is a disorder in which reflux of stomach contents causes troublesome symptoms and/or complications and which affects health-related quality of life. It is one of the commonest disorders and appears to be increasing in incidence. The mechanisms leading to reflux are complex and multifactorial. The lower oesophageal sphincter (LES is an important part of the gastro-oesophageal barrier. Transient LES relaxations (TLESRs lead to reflux as these vagally mediated motor patterns cause relaxation of the LES and also result in oesophageal shortening and inhibition of the crural diaphragm. Heartburn and regurgitation are the characteristic symptoms of GERD. A clinical diagnosis of GERD can be made with typical symptoms. Oesophagitis is seen in a minority of patients with GERD. Lifestyle modification is widely advocated for patients with GERD. For short-term relief of symptoms of mild GERD, antacids/alginates are frequently used but they do not heal oesophagitis. Both histamine 2 receptor antagonists (H2RA and proton pump inhibitors (PPI have been shown to heal and prevent relapse of oesophagitis, although PPIs have been shown to be superior. The PPIs are the recommended first-line therapy for erosive oesophagitis and initial management of non-erosive reflux disease. Maintenance PPI therapy should be given to patients with oesophagitis, those who have recurrence of symptoms after discontinuation of medication and for those with complications of GERD.

  17. Effect of a new benzodiazepine derivate, clobazam, in anxious patients with gastrointestinal disorders. (United States)

    Laudano, O; Peralta, M; Lujan, L; Aparicio, N; Moizeszowicz, J


    Thirty-four anxious patients with gastrointestinal disorders were studied in order to evaluate the effectiveness of a new 1,5-benzodiazepine antianxiety agent (HR 376). The disorders were classified as organic or functional according to the presence or absence of radiologic signs of ulcer. Dietetic measures, gastric antacids, anticholinergic agents, and antianxiety treatment were applied for six weeks. Anxiolytic treatment consisted of 30 mg/day clobazam (HR 376) or 15 mg/day diazepam, given in a randomized, double-blind manner. Clinical follow-up was performed with the PEN Personality Inventory (PEN), Taylor Manifest Anxiety Scale (TMAS), Hamilton Anxiety Scale (HAS), and Wittenborn Psychiatric Rating Scales (WPRS). The score of the psychoticism dimension of the PEN inventory was significantly higher in organic than in functional patients. Significant differences occurred in the reduction of the rating scores of HAS and WPRS before/after treatment in the clobazam and diazepam groups. This would express a modification of state anxiety. The TMAS, which evaluates trait anxiety, disclosed statistically significant improvement in the clobazam group. This group showed an early reduction of the HAS and TMAS scores, which would suggest an early onset of action.

  18. The effect of ferrous sulphate and sucralfate on the bioavailability of oral gemifloxacin in healthy volunteers. (United States)

    Allen, A; Bygate, E; Faessel, H; Isaac, L; Lewis, A


    Sucralfate is a cytoprotectant with antacid properties and ferrous sulphate is commonly prescribed for iron-deficiency anaemia. This open, randomized, single-dose, five-way crossover study investigated the effect of sucralfate and ferrous sulphate on the bioavailability of gemifloxacin, a novel fluoroquinolone antimicrobial. Twenty-seven healthy male volunteers received gemifloxacin, 320 mg p.o., alone, 3 h after sucralfate (2 g) or ferrous sulphate (325 mg), or 2 h before sucralfate or ferrous sulphate. Each subject received all five dosing regimens in random order with at least 6 days between regimens. Plasma samples collected up to 48 h after dosing with gemifloxacin, were assayed for gemifloxacin to determine pharmacokinetic parameters. Administration of gemifloxacin 3 h after sucralfate produced a marked decrease of 53% in the area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-infinity), and a decrease of 69% in the maximal plasma concentration (Cmax). Administration of gemifloxacin 3 h after ferrous sulphate resulted in only a modest reduction of 11% in AUC0-infinity and of 20% in Cmax, which was not considered to be clinically significant. In contrast, at the doses used neither sucralfate nor ferrous sulphate altered gemifloxacin bioavailability when it was administered 2 h before either of these agents. Gemifloxacin was well tolerated in all the regimens. The results of this study support the dosing recommendation that gemifloxacin can be safely administered at least 2 h before sucralfate or ferrous sulphate, or at least 3 h after ferrous sulphate.

  19. Laparoscopically Assisted Proximal Gastrectomy with Esophagogastrostomy Using a Novel "Open-Door" Technique : LAPG with Novel Reconstruction. (United States)

    Hosoda, Kei; Yamashita, Keishi; Moriya, Hiromitsu; Mieno, Hiroaki; Ema, Akira; Washio, Marie; Watanabe, Masahiko


    Laparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy using a novel "open-door" technique was introduced recently, with the aim of preventing gastroesophageal reflux. However, quantitate assessment of gastroesophageal reflux after this surgery has not been performed till date. The aims of the current study were to investigate the safety and feasibility of this operation and to elucidate the postoperative reflux status. Twenty consecutive patients (18 men) with (y)cStage I gastric cancer in the upper third of the stomach who underwent LAPG at Kitasato University Hospital from May 2015 through September 2016 were retrospectively reviewed. We performed 24-h impedance-pH monitoring 3 months after surgery for the first eight patients and analyzed the postoperative reflux status. Median operation time was 333 min, while median anastomotic time was 81 min. None of the 20 patients experienced anastomotic leakage while two patients experienced anastomotic stricture requiring endoscopic balloon dilatation. No patient experienced heartburn without antacid drugs. During the 24-h impedance-pH monitoring, all but one patient had normal gastroesophageal acid reflux with the acid percent time of technique is a safe and feasible procedure for LAPG. The degree of gastroesophageal reflux was acceptable using this technique. Randomized controlled trials with long-term follow-ups are required to confirm that this technique would be superior to the others.

  20. Roxatidine acetate in the long term maintenance of gastric ulcers. (United States)

    Börsch, G


    A non-comparative multicentre study of 78 patients with healed gastric ulcers who had received roxatidine acetate was conducted to determine the ulcer recurrence rates during 6 months' maintenance therapy with roxatidine acetate 75 mg at night. Gastric ulcer relapses occurred in 35% of patients, representing a worst possible outcome estimate, with no significant differences between smokers and non-smokers although heavy smoking appeared to increase the rate of relapse. The incidence of epigastric pain did not significantly increase over the duration of therapy and while some patients complained of mild pain at the start of the trial all subjects had endoscopically confirmed healed ulcers. The consumption of antacids for symptom relief was low, reaching an average of 0.75 tablets a day which was insufficient to influence intragastric pH. Continuous poor appetite and pyrosis were reported by about 5% of subjects. Of 2 patients who complained of mild to moderate side effects, 1 discontinued treatment. In addition, there were no clinically significant changes in haematological and biochemical variables. Thus, maintenance therapy with roxatidine acetate 75 mg at night is safe and generally effective in preventing symptomatic relapse.

  1. A comparison of roxatidine acetate 150 mg once daily and 75 mg twice daily in duodenal ulcer healing. (United States)

    Hentschel, E; Schütze, K


    A randomised multicentre, double-blind study of the efficacy and safety of roxatidine acetate 150 mg at bedtime or 75 mg twice a day was conducted in 300 outpatients with endoscopically confirmed duodenal ulcers. After 14 days' treatment with roxatidine acetate substantial reductions in ulcer sizes had been obtained, in addition to healing rates of 87 to 89%, with no significant differences between the dosage regimens. There were graded reductions in day and night-time assessment of epigastric pain for both treatment groups and no differences in the mean numbers of antacid tablets consumed. In addition, cigarette smoking did not influence the healing rates produced by either treatment schedule. 11 patients reported 12 mild adverse reactions, with gastrointestinal symptoms the most frequent, and no clinically significant alterations in laboratory values. The present data suggests that a single bedtime dose of roxatidine acetate 150 mg produces effective duodenal ulcer healing and pain relief equivalent to that produced by a twice daily dosage regimen.

  2. Roxatidine versus ranitidine in the treatment of duodenal ulcers: a randomized double-blind controlled multicentre study in Singapore. (United States)

    Fock, K M; Kang, J Y; Ng, H S; Ng, T M; Gwee, K A; Lim, C C


    Roxatidine acetate, a new H2 receptor antagonist, was compared with ranitidine in the treatment of duodenal ulcers in a double-blind multicentre study. Eighty-four patients with endoscopically proven duodenal ulcer were randomized to receive 150 mg roxatidine acetate or 300 mg ranitidine at bedtime. Repeat endoscopy was performed after 4 weeks (25-33 days) and if the ulcer had not healed, another endoscopy was performed after a further 4 weeks of treatment. Using per protocol analysis 73.6% of ulcers treated with roxatidine healed at 4 weeks compared to 72.2% of ulcers treated with ranitidine (P = NS). The healing rates at 8 weeks were 92% with roxatidine and 83.3% with ranitidine (P = NS). Using equivalence tests, the healing rate of roxatidine was found to be equivalent to that of ranitidine within a 20% region. Roxatidine users took significantly less antacids than ranitidine users (P roxatidine or ranitidine. Roxatidine is a safe effective drug in the treatment of duodenal ulcers with a healing rate comparable to that of ranitidine.

  3. A comparison of roxatidine acetate and ranitidine in gastric ulcer healing. (United States)

    Judmaier, G


    A randomised multicentre double-blind study was conducted to compare the efficacy and safety of roxatidine acetate 75 mg twice daily and ranitidine 150 mg twice daily in 295 patients with endoscopically confirmed gastric ulcers. Substantial reductions in ulcer diameters and healing rates of 85.6 and 88.2% for roxatidine acetate and ranitidine, respectively, were obtained after 8 weeks of treatment. There was no difference in healing rates between smokers and non-smokers in either group. The relief of day and night-time epigastric pain was comparable for both treatment groups, as was antacid tablet consumption, with the majority of patients pain-free at the end of the study. The incidence of side effects was low, with 3 patients treated with roxatidine acetate, compared with 4 ranitidine-treated patients, reporting adverse reactions. There were no clinically significant changes in laboratory values. The present study suggests that 8 weeks of treatment with roxatidine acetate 75 mg twice a day produces effective and safe acute management of gastric ulcers which is comparable to that seen with ranitidine.

  4. A comparison of roxatidine acetate and ranitidine in duodenal ulcer healing. (United States)

    Hüttemann, W


    A randomised double-blind study was conducted to compare the efficacy of roxatidine acetate 75 mg twice daily with ranitidine 150 mg twice daily in 308 patients with endoscopically confirmed uncomplicated duodenal ulcers. After 6 weeks of treatment ulcer healing was found in 93.5% of the roxatidine acetate group and 89.2% of the ranitidine group, with no significant differences between treatment groups. The relief of day and night-time epigastric pain assessed at clinic visits or on diary cards by patients was comparable for both treatment groups, as was the consumption of antacid tablets for relief of symptoms of dyspepsia. There were no significant differences in the healing rates of smokers and non-smokers for either roxatidine acetate or ranitidine treatment, and no clinically significant alterations in laboratory values. Eight patients in the roxatidine acetate group and 1 in the ranitidine group complained of mild side effects, which included diarrhoea, constipation and headache. One patient on roxatidine acetate withdrew from treatment because of a mild skin rash. The results confirm that roxatidine acetate is a safe and effective treatment for duodenal ulcer disease.

  5. Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population

    Institute of Scientific and Technical Information of China (English)

    Shou-Wu Lee; Chia-Ming Chang; Chi-Sen Chang; Ai-Wen Kao; Ming-Chih Chou


    AIM: To compare the presentation and impact on quality of life of gastroesophageal reflux disease (GERD) in old and young age groups.METHODS: Data from adult patients with GERD diagnosed by endoscopic and symptomic characteristics were collected between January and November 2009. Exclusion criteria included combined peptic ulcers, malignancy,prior surgery, antacid medication for more than 2 mo, and pregnancy. Enrolled patients were assigned to the elderly group if they were 65 years or older, or the younger group if they were under 65 years. They had completed the GERD impact scale, the Chinese GERD questionnaire, and the SF-36 questionnaire.Data from other cases without endoscopic findings or symptoms were collected and these subjects comprised the control group in our study.RESULTS: There were 111 patients with GERD and 44 normal cases: 78 (70.3%) and 33 patients (29.7%) were in the younger and elderly groups, respectively. There were more female patients (60.3%) in the younger group, and more males (72.7%) in the elderly group. The younger cases had more severe and frequent typical symptoms than the elderly patients. Significantly more impairment of daily activities was noted in the younger patients compared with the elderly group, except for physical functioning.CONCLUSION: Elderly patients with GERD were predominantly male with rare presentation of typical symptoms,and had less impaired quality of life compared with younger patients in a Chinese population.

  6. Effect of fibers on Hybrid Matrix Composites

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    Full Text Available Frictional co-efficient, impact quality; dielectric quality and compound resistance examination of bamboo/glass strands strengthened epoxy half breed composites were considered. Two distinctive crossover composites, for example, treated and untreated bamboo filaments were manufactured and impact of soluble base treatment of the bamboo strands on these properties were additionally concentrated on. It was watched that, effect quality and frictional co-proficient properties of the half and half composites increment with expansion in glass fiber content. These properties observed to be higher when salt treated bamboo filaments were utilized as a part of the half breed composites. It is watched that, concoction resistance was fundamentally increments for all chemicals with the exception of carbon tetrachloride. The disposal of nebulous hemi-cellulose with salt treatment prompting higher crystallinity of the bamboo filaments with antacid treatment may in charge of these perceptions. The impact of salt treatment on the holding between glass/bamboo composites was additionally concentrated on. Checking electron magnifying lens (SEM were additionally directed on the cross segments of broke surfaces with a specific end goal to rate the execution crossover composites were likewise conferred bear natural products.

  7. [Guidelines for the treatment of functional dyspepsia]. (United States)

    Jee, Sam Ryong; Jung, Hye Kyung; Min, Byung Hoon; Choi, Kee Don; Rhee, Poong Lyul; Kang, Young Woo; Lee, Sang In


    Functional dyspepsia (FD) is defined as the presence of symptoms thought to originate in the gastroduodenal area, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Based on the available evidence and consensus opinion, thirteen consensus statements for the treatment of FD were developed using the modified Delphi approach. Proton pump inhibitor, prokinetics, and histamine 2 receptor antagonists are effective for the treatment of FD. Mucosal protecting agents, fundus relaxant, and drugs for visceral hypersensitivity can improve symptoms in FD. Antacids and antidepressants may help improving symptoms in FD. Comparing endoscopy with 'test and treat' of Helicobacter pylori, endoscopy may be more effective initial strategy for managing patients with FD in Korea given high incidence of gastric cancer and low cost of endoscopy. Helicobacter pylori eradication can be one of the therapeutic options for patients with FD. Psychotherapy is effective for those who have severe symptoms and refractoriness. Further studies are strongly needed to develop better treatment strategies for Korean patients with FD.

  8. Clinical course, prognosis and prevention of acute postoperative erosive and ulcerative lesions of gastroduodenal zone in older patients

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    Shapkin Y.G.


    Full Text Available Objective of the research is to improve the results of surgical treatment in patients with postoperative acute bleeding erosions and ulcers of stomach and duodenum by their prediction and validation of methods for prevention and treatment. Materials and methods. A retrospective analysis of 3746 case histories of patients has been made. Acute erosive and ulcerative lesions, complicated by gastroduodenal bleeding, have been diagnosed in 220 cases (5, 9% in the postoperative period. Older patients have been accounted 62, 8%. Results. Acute erosive and ulcerative lesions have been developed in 5.6% of all operated patients of older age, and 0,3% in patients of middle age. Mortality rate in older patients with bleeding acute erosive and ulcerative lesions has accounted 35,8. Conclusion. The development of gastroduodenal acute erosive and ulcerative lesions is considered to be a risk factor degenerating condition of older patients in the postoperative period. The main areas of acute erosive and ulcerative lesions treatment are antisecretory therapy and endoscopic hemostasis. Endoscopic hemostasis should be accompanied by good antisecretory treatment with antacid effect in the stomach. The use of injections of H2-blockers does not prevent bleeding recurrences

  9. Ranitidine and placebo in the treatment of reflux oesophagitis. A double-blind randomized trial. (United States)

    Goy, J A; Maynard, J H; McNaughton, W M; O'Shea, A


    A study was carried out to assess the effectiveness of ranitidine in the short-term treatment of reflux oesophagitis. In a double-blind randomized trial of 37 outpatients with symptomatic, endoscopically proven, moderate or severe reflux oesophagitis, 18 patients received ranitidine (150 mg twice a day) and 19 patients received identical-looking placebo tablets for a period of six weeks. Clinical, laboratory, and endoscopic assessments were made initially, and at the end of six weeks. Two patients withdrew during the trial. Endoscopic evidence of improvement was found in 15 of 17 ranitidine-treated and in five of 18 placebo-treated patients. This difference was significant (P less than 0.01). Antacid consumption was significantly lower in the ranitidine-treated group (P less than 0.01). Improvement in histological findings, and the relief of retrosternal pain, regurgitation, dysphagia, and epigastric pain did not achieve levels of statistical significance. No adverse clinical or laboratory changes occurred in patients in either group. It is concluded that, as judged by endoscopic evidence, ranitidine is an effective drug for the short-term treatment of reflux oesophagitis.

  10. Clinical aspects of cobalamin deficiency in elderly patients. Epidemiology, causes, clinical manifestations, and treatment with special focus on oral cobalamin therapy. (United States)

    Andrès, Emmanuel; Vidal-Alaball, Josep; Federici, Laure; Loukili, Noureddine Henoun; Zimmer, Jacques; Kaltenbach, Georges


    The aim of this work was to review the literature concerning cobalamin deficiency in elderly patients. Articles were identified through searches of PubMed-MEDLINE (January 1990 to June 2006), restricted to: English and French language, human subjects, elderly patients (>65 years), clinical trial, review and guidelines. Additional unpublished data from our cohort with cobalamin deficiency at the University Hospital of Strasbourg, France, were also considered. All of the papers and abstracts were reviewed by at least two senior researchers who selected the data used in the study. In elderly people, the main causes of cobalamin deficiency are pernicious anemia and food-cobalamin malabsorption. The recently identified food-cobalamin malabsorption syndrome is a disorder characterized by the inability to release cobalamin from food or from its binding proteins. This syndrome is usually the consequence of atrophic gastritis, related or not to Helicobacter pylori infection, and of the long-term ingestion of antacids and biguanides (in around 60% of the patients). Management of cobalamin deficiency has been well established with the use of cobalamin injections. However, new routes of cobalamin administration (oral and nasal) are currently being developed, especially the use of oral cobalamin therapy to treat food-cobalamin malabsorption.

  11. Evaluation of preservative effectiveness of p-coumaric acid derivatives in aluminium hydroxide gel-USP

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    Anurag Khatkar


    Full Text Available Background: Deterioration of pharmaceutical preparations due to growth of microorganisms is a great challenge and need of preservation becomes very important. Literature reports about various problems associated with the existing synthetic preservatives such as development of microbial resistance (in due course of time and several serious side effects. Aim: The aim of the present study is to find out new preservatives synthesized from natural sources, which may have better efficiency than the existing synthetic preservatives. The derivatives of naturally occurring p-coumaric acid were subjected for their preservative efficacy study. Their preservative efficiency was evaluated and compared with the standard parabens. Materials and Methods: The selected amide, anilide and ester derivatives of p-coumaric acid were subjected to preservative efficacy testing in an official antacid preparation, (aluminium hydroxide gel-USP against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Candida albicans and Aspergillus niger as representative challenging microorganisms as per USP 2004 guidelines. Results: The selected derivatives were found to be effective against all selected strains and showed preservative efficacy comparable to that of standard and even better in case E. coli, C. albicans and A. niger. The 8-hydroxy quinoline ester derivative showed better preservative efficacy than standard as well as other derivatives. Conclusion: The newly synthesized p- coumaric acid preservatives were found to be effective in the proposed pharmaceutical preparation (Aluminium Hydroxide Gel - USP. Also, the synthesized preservatives have shown comparative and even better efficacy than the existing parabens and hence they have potential for use in pharmaceutical preparations.

  12. Evaluation of preservative effectiveness of gallic acid derivatives in aluminum hydroxide gel-USP

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    Anurag Khatkar


    Full Text Available Background: Preservatives are added to most of the pharmaceutical preparations to prevent them from deterioration throughout their shelf life. Literature reveals that the common synthetic preservatives have many limitations, such as development of microbial resistance (in due course of time and several serious side-effects. Aim: The aim of this study is to find out new preservatives synthesized from natural sources, which may have better efficiency than the existing synthetic preservatives. The derivatives of naturally occurring gallic acid were subjected for their preservative efficacy study. Their preservative efficiency was evaluated and compared with the standard parabens. Materials and Methods: The selected amide, anilide and ester derivatives of gallic acid were subjected to preservative efficacy testing in an official antacid preparation, {aluminum hydroxide gel-USP (United States Pharmacopoeia} against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Candida albicans, and Aspergillus niger as representative challenging microorganisms as per USP 2004 guidelines. Results: The selected derivatives were found to be effective against all selected strains and showed preservative efficacy comparable to that of standard and even better in case E. coli, C. albicans and A. niger. The 8-hydroxy quinoline ester derivative showed better preservative efficacy than standard as well as other derivatives. Conclusion: The newly synthesized gallic acid preservatives were found to be effective in the proposed pharmaceutical preparation (Aluminium Hydroxide Gel - USP. Also, the synthesized preservatives have shown comparative and even better efficacy than the existing parabens and hence they have potential for use in pharmaceutical preparations.

  13. Causes of ventilator associated pneumonia in pediatrics ICU

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    Alireza Nateghian


    Full Text Available Background: Hospital acquired infections are associated with prolonged hospitalization and visibly increased mortality & cost. Ventilator-associated pneumonia (VAP is one of the most common hospital-acquired infections VAP complicates the course of 9-70% % of mechanically ventilated patients and mortality varies greatly from 20-25% depending on the defining criteria and specific population being studied. As little is known about the epidemiology, risk factors, and microbiology of VAP in pediatrics we conducted this study to find most common micro-organisms and related risk factors. Materials and methods: We select 1-15 months intubated pediatric patients in Ali- Asghar children hospital in Tehran from 1388 up to end of 1389. 63 cases (36 male & 27 female were included in this study with mean age 22.32±37.84 months. We identified 26 cases with VAP by positive protected bronchial brush. There was no differences between two groups of patients with & without VAP by considering variables such as nasogastric tube, head position, antacid administration, immunosuppressant drugs & chest physiotherapy. Results: The most common organisms, were Pseudomonas aeuroginosa, Staphylococcus aureus & Enterobacter. However, there was no differences between two groups related to the etiologic agents. Conclusion: The findings of this study suggest that most of the complications defined as VAP are patient-related, not modifiable risk factors and it seems that the new prevention strategies are needed to decrease the mortality in intensive care unit patients

  14. Toxoplasma gondii vs ionizing radiation: intestinal immunity induced in C57bl/6j mice by irradiated tachyzoites; Toxoplasma gondii vs radiacao ionizante: estudo da imunidade intestinal em camundongos C57Bl/6j experimentalmente vacinados com taquizoitos irradiados

    Energy Technology Data Exchange (ETDEWEB)

    Galisteo Junior, Andres Jimenez. E-mail:


    We study the oral route for the development of a vaccine for toxoplasmosis, using parasites irradiated with 60 Cobalt, as an alternative for vaccine development to this worldwide parasitic infection. We evaluated the development of immunity at serum or mucosal levels, and their efficiency in protect the mice against challenge with oral cysts of the Me-49 strain. C57Bl/6j isogenic mice were immunized by oral route with 107 255 Gy irradiated tachyzoites from RH strain, at several protocols using milk as anti-peptic adjuvant and alum hydroxide as antacid. The preparations of irradiated tachyzoites induced production of serum IgG and IgA in immunized mice, as determined by ELISA, with IgG2a as the dominant subclass, similar to chronic infection. Their use with adjuvant allowed the excretion of significant amounts of IgA in stools also IgG, despite a lesser extent. There are suggestion of tolerance induction at mucosal level, with lower antigen induced proliferation and lower in vitro antibody production by spleen and gut lymphocytes, with the latter doses, specially when milk was used as adjuvant. All oral preparations induced some quantitative protection against challenge, which was similar to the parenteral route only isolated alum hydroxide was used as adjuvant. All these data support the possibility of the development of an oral vaccine against toxoplasmosis, using irradiated tachyzoites, which would be possible tool in near future for use in field baits, for immunizing either domestic or wild felines. (author)

  15. Oral dosing with papaya latex is an effective anthelmintic treatment for sheep infected with Haemonchus contortus

    Directory of Open Access Journals (Sweden)

    Donnan Alison A


    Full Text Available Abstract Background The cysteine proteinases in papaya latex have been shown to have potent anthelmintic properties in monogastric hosts such as rodents, pigs and humans, but this has not been demonstrated in ruminants. Methods In two experiments, sheep were infected concurrently with 5,000 infective larvae of Haemonchus contortus and 10,000 infective larvae of Trichostrongylus colubriformis and were then treated with the supernatant from a suspension of papaya latex from day 28 to day 32 post-infection. Faecal egg counts were monitored from a week before treatment until the end of the experiment and worm burdens were assessed on day 35 post-infection. Results We found that the soluble fraction of papaya latex had a potent in vivo effect on the abomasal nematode H. contortus, but not on the small intestinal nematode T. colubriformis. This effect was dose-dependent and at tolerated levels of gavage with papaya latex (117 μmol of active papaya latex supernatant for 4 days, the H. contortus worm burdens were reduced by 98%. Repeated treatment, daily for 4 days, was more effective than a single dose, but efficacy was not enhanced by concurrent treatment with the antacid cimetidine. Conclusions Our results provide support for the idea that cysteine proteinases derived from papaya latex may be developed into novel anthelmintics for the treatment of lumenal stages of gastro-intestinal nematode infections in sheep, particularly those parasitizing the abomasum.

  16. Is Sodium Bicarbonate Therapy Still Up To Date?

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    Hüseyin Kurt


    Full Text Available Sodium bicarbonate (SB, which has a vital role in the regulation of acid-base balance of all tissues and organs, is one of the most important buffering systems of the body. SB plays an important role in the treatment of poisoning caused by numerous agents including mainly salicylate and tricyclic antidepressants. In metabolic acidosis (MA occurred in patient with systemic and metabolic diseases, first, the primary disease should be treated and in the case of low bicarbonate levels such as diarrhea and renal tubular acidosis, missing SB should be recovered. As the kidney has an important role in acid-base balance, SB is widely used in the treatment of acute and chronic renal failure. Although there is no conclusive evidence to prevent contrast nephropathy, SB comes to the fore compared to other agents. SB is used due to MA and its effects occurring in acute renal failure. In addition, SB treatment applied to reduce the increased acid levels in chronic kidney failure may reduce mortality. While SB can be used as individualized in lactic acidosis and cardiac arrest cases, it can be used safely as a performance enhancer for athletes. SB is used widely in gastrointestinal tract diseases due to its antacid effects and its routine use is not recommended in diabetic ketoacidosis. These data demonstrate that SB is still popular and it will retain its popularity in the near future.

  17. [Medication as a risk factor for falls resulting in severe fractures in the elderly]. (United States)

    Coutinho Ed, Evandro da Silva Freire; Silva, Sidney Dutra da


    Falls leading to fractures among the elderly are a major public problem. A case-control study was conducted on the use of certain drugs as a risk factor for hospitalization due to fractures after falls among individuals aged 60 years or over in the city of Rio de Janeiro, Brazil. One hundred sixty-nine cases and 315 in-patient controls were matched by age, sex, and hospital. Odds ratios (OR) adjusted for potential confounders were calculated using conditional logistic regression. Increased risk of such accidents was found for calcium channel antagonists (OR = 1.96, 1.16-3.30) and benzodiazepines (OR = 2.09, 1.08-4.05), and decreased risk was associated with diuretics (OR = 0.40, 0.20-0.80). Antacids, digitalis, and laxatives were associated with reduced risk of fractures after falls that reached borderline statistical significance (0.05 < p < 0.10). The findings highlight the need to weigh risks and benefits of medication in the elderly. It is also important to advise such individuals and their families on how to avoid falls when such medication proves necessary.

  18. Analysis of the diagnosis and treatment of 78 gastric cancer cases in young people%78例青年人胃癌的临床诊疗过程分析

    Institute of Scientific and Technical Information of China (English)

    周恩相; 文明星; 李允山


    Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric cancer in young people (14-35 years). Results: The clinical manifestations of gastric carcinoma in young people show no specificity, and the initial symptoms were diverse, with discomfort in the upper abdomen as the main symptom. There are four causes of difficulty in early detection: (1) The previous physician relied on antacids and did not use or analyze the results of gastroscopic examination and barium meal examination of the upper digestive tract; (2) The physician performing the endoscopic examination did not strictly follow the standards in the biopsy of fine pathological changes in suspected early cancer; (3) The physician lacked a good understanding of the clinical progress of ulcerating-healing-ulcerating in the ulcerating type of early gastric cancer; (4) Lacked a good understanding of precancerous lesions in the gastric mucosa. Conclusion: Early gastroscopy and pathological examination must be conducted for people who above 20 years of age with one or more of the following symptoms: dull pain in the upper abdomen, anorexia, fatigue, tarry stool and vomiting of unknown origin. The results of gastroscopic examination should be taken into consideration for patients with recurrent ulcer, and biopsy should be standardized. Biopsy specimens should be taken from several loci in the suspected lesions, and should be repeated if necessary. Precancerous lesions of gastric mucosa should be closely followed up using gastroscopy.

  19. Associations between acetaminophen use during pregnancy and ADHD symptoms measured at ages 7 and 11 years.

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    John M D Thompson

    Full Text Available OBJECTIVE: Our aim was to replicate and extend the recently found association between acetaminophen use during pregnancy and ADHD symptoms in school-age children. METHODS: Participants were members of the Auckland Birthweight Collaborative Study, a longitudinal study of 871 infants of European descent sampled disproportionately for small for gestational age. Drug use during pregnancy (acetaminophen, aspirin, antacids, and antibiotics were analysed in relation to behavioural difficulties and ADHD symptoms measured by parent report at age 7 and both parent- and child-report at 11 years of age. The analyses included multiple covariates including birthweight, socioeconomic status and antenatal maternal perceived stress. RESULTS: Acetaminophen was used by 49.8% of the study mothers during pregnancy. We found significantly higher total difficulty scores (Strengths and Difficulty Questionnaire parent report at age 7 and child report at age 11 if acetaminophen was used during pregnancy, but there were no significant differences associated with any of the other drugs. Children of mothers who used acetaminophen during pregnancy were also at increased risk of ADHD at 7 and 11 years of age (Conners' Parent Rating Scale-Revised. CONCLUSIONS: These findings strengthen the contention that acetaminophen exposure in pregnancy increases the risk of ADHD-like behaviours. Our study also supports earlier claims that findings are specific to acetaminophen.

  20. Epigastric Distress Caused by Esophageal Candidiasis in 2 Patients Who Received Sorafenib Plus Radiotherapy for Hepatocellular Carcinoma: Case Report. (United States)

    Chen, Kuo-Hsin; Weng, Meng-Tzu; Chou, Yueh-Hung; Lu, Yueh-Feng; Hsieh, Chen-Hsi


    Sorafenib followed by fractionated radiotherapy (RT) has been shown to decrease the phagocytic and candidacidal activities of antifungal agents due to radiosensitization. Moreover, sorafenib has been shown to suppress the immune system, thereby increasing the risk for candida colonization and infection. In this study, we present the 2 hepatocellular carcinoma (HCC) patients suffered from epigastric distress caused by esophageal candidiasis who received sorafenib plus RT. Two patients who had received sorafenib and RT for HCC with bone metastasis presented with hiccups, gastric ulcer, epigastric distress, anorexia, heart burn, and fatigue. Empiric antiemetic agents, antacids, and pain killers were ineffective at relieving symptoms. Panendoscopy revealed diffuse white lesions in the esophagus. Candida esophagitis was suspected. Results of periodic acid-Schiff staining were diagnostic of candidiasis. Oral fluconazole (150 mg) twice daily and proton-pump inhibitors were prescribed. At 2-weak follow-up, esophagitis had resolved and both patients were free of gastrointestinal symptoms. Physicians should be aware that sorafenib combined with RT may induce an immunosuppressive state in patients with HCC, thereby increasing their risk of developing esophagitis due to candida species.

  1. Risks of Using Bedside Tests to Verify Nasogastric Tube Position in Adult Patients

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    Melody Ni


    Full Text Available Nasogastric (NG tubes are commonly used for enteral feeding. Complications of feeding tube misplacement include malnutrition, pulmonary aspiration, and even death. We built a Bayesian network (BN to analyse the risks associated with available bedside tests to verify tube position. Evidence on test validity (sensitivity and specificity was retrieved from a systematic review. Likelihood ratios were used to select the best tests for detecting tubes misplaced in the lung or oesophagus. Five bedside tests were analysed including magnetic guidance, aspirate pH, auscultation, aspirate appearance, and capnography/colourimetry. Among these, auscultation and appearance are non-diagnostic towards lung or oesophagus placements. Capnography/ colourimetry can confirm but cannot rule out lung placement. Magnetic guidance can rule out both lung and oesophageal placement. However, as a relatively new technology, further validation studies are needed. The pH test with a cut-off at 5.5 or lower can rule out lung intubation. Lowering the cut-off to 4 not only minimises oesophageal intubation but also provides extra safety as the sensitivity of pH measurement is reduced by feeding, antacid medication, or the use of less accurate pH paper. BN is an effective tool for representing and analysing multi-layered uncertainties in test validity and reliability for the verification of NG tube position. Aspirate pH with a cut-off of 4 is the safest bedside method to minimise lung and oesophageal misplacement.

  2. Aluminium and breast cancer: Sources of exposure, tissue measurements and mechanisms of toxicological actions on breast biology. (United States)

    Darbre, Philippa D; Mannello, Ferdinando; Exley, Christopher


    This review examines recent evidence linking exposure to aluminium with the aetiology of breast cancer. The human population is exposed to aluminium throughout daily life including through diet, application of antiperspirants, use of antacids and vaccination. Aluminium has now been measured in a range of human breast structures at higher levels than in blood serum and experimental evidence suggests that the tissue concentrations measured have the potential to adversely influence breast epithelial cells including generation of genomic instability, induction of anchorage-independent proliferation and interference in oestrogen action. The presence of aluminium in the human breast may also alter the breast microenvironment causing disruption to iron metabolism, oxidative damage to cellular components, inflammatory responses and alterations to the motility of cells. The main research need is now to investigate whether the concentrations of aluminium measured in the human breast can lead in vivo to any of the effects observed in cells in vitro and this would be aided by the identification of biomarkers specific for aluminium action.

  3. Multifaceted effects of aluminium in neurodegenerative diseases: A review. (United States)

    Maya, S; Prakash, T; Madhu, Krishna Das; Goli, Divakar


    Aluminium (Al) is the most common metal and widely distributed in our environment. Al was first isolated as an element in 1827, and its use began only after 1886. Al is widely used for industrial applications and consumer products. Apart from these it is also used in cooking utensils and in pharmacological agents, including antacids and antiperspirants from which the element usually enters into the human body. Evidence for the neurotoxicity of Al is described in various studies, but still the exact mechanism of Al toxicity is not known. However, the evidence suggests that the Al can potentiate oxidative stress and inflammatory events and finally leads to cell death. Al is considered as a well-established neurotoxin and have a link between the exposure and development of neurodegenerative diseases, including Amyotrophic Lateral Sclerosis (ALS), Alzheimer's disease (AD), dementia, Gulf war syndrome and Parkinsonism. Here, we review the detailed possible pathogenesis of Al neurotoxicity. This review summarizes Al induced events likewise oxidative stress, cell mediated toxicity, apoptosis, inflammatory events in the brain, glutamate toxicity, effects on calcium homeostasis, gene expression and Al induced Neurofibrillary tangle (NFT) formation. Apart from these we also discussed animal models that are commonly used for Al induced neurotoxicity and neurodegeneration studies. These models help to find out a better way to treat and prevent the progression in Al induced neurodegenerative diseases.

  4. [Giant gastric ulcer by cytomegalovirus in infection VIH/SIDA]. (United States)

    Pérez-Pereyra, Julia; Morales, Domingo; Díaz, Ramiro; Yoza, Max; Frisancho, Oscar


    Cytomegalovirus infection is an important cause of morbidity in immunosupressed patients with Human Immunodeficiency Virus (HIV). In this paper we present a 43 years old man with renal failure under hemodialysis, several blood transfusions because of anemia and three months of disease characterized by epigastric pain, specially at nights, ameliorated with antacid drugs. Other symptoms were early satisfy, vomits and weigh loss (18Kg). At clinical exam, the patient was pallid, presented adenopathies at cervical and inguinal regions and had a pain at epigastric region in profound touch palpation. The most important exams were HB: 10mg/dl, CMV: 83.5, leukocytes 7000, lymphocytes: 1715, erythrocyte sedimentation rate 49mm/h, the venon test (-), and Giardia lamblia trophozoites in stools. The studies demonstrated the patient was seropositive for HIV and the tests for IgG CMV and IgG Herpes virus resulted seropositives too. At endoscopy the esophagus mucosa was covered by a white plaque which suggests candida infection. In the stomach, over the body gastric, we found a big and deep ulcerated lesion (45 x 41mm), with defined rims and white fund. Biopsy from the edges of the gastric ulcer had the characteristic CMV intranuclear and intracytoplasmic inclusions; we confirmed the diagnosis by immunohystochemistry. The patient receives ganciclovir an then HAART and is getting well.

  5. The Importance of Chitosan Films in Food Industry

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    Filiz Uçan


    Full Text Available Requirement simple technology, low production costs, lack of polluting effects and reliability in terms of health of it is the most important advantages of edible films. Chitosan that extend the shelf life of food and increase the economic efficiency of packaging materials is one of the new materials used for edible films. Chitosan was obtained by deacetylation of chitin which is the most commonly occurred polymer after cellulose in nature, in shells of arthropods such as crab, shrimp, lobster and in cell walls of some bacteria and fungi. Chitosan has the important bioactive properties such as hemostatic, bacteriostatic, fungistatic, spermicidal, anticarcinogenic, anticholesteremic, antacids, antiulcer, wound and bone healing accelerator and stimulating the immune system. As well as these features, the film forming and barrier properties of its, chitosan is made the ideal material for edible films and coatings in antimicrobial characters. Especially, in the protection of qualities and the improving storage times of fruits and vegetables, have been revealed the potential use of chitosan. The coating food with chitosan films reduces the oxygen partial pressure in the package, maintains temperature with moisture transfer between food and its environment, declines dehydration, delays enzymatic browning in fruits and controls respiration. In addition to, chitosan are also used on issues such as the increasing the natural flavour, setting texture, increasing of the emulsifying effect, stabilization of color and deacidification.

  6. Ofloxacin. (United States)

    Tunkel, A R; Scheld, W M


    Ofloxacin is a newly licensed fluoroquinolone with an antimicrobial spectrum similar to ciprofloxacin. Compared with ciprofloxacin, the MIC90 values for ofloxacin are lower for S aureus, C trachomatis, and Ureaplasma urealyticum, but somewhat higher against gram-negative bacteria (especially P aeruginosa). Ofloxacin has favorable pharmacokinetics with almost 100% bioavailability; peak serum concentrations obtained one to two hours following oral dosing are higher than those achieved with ciprofloxacin. The oral bioavailability is decreased by the coadministration of antacids, but ofloxacin does not alter serum theophylline concentrations. Ofloxacin has demonstrated bacteriologic and clinical efficacy in the treatment of urinary tract infections, respiratory tract infections, prostatitis, and skin and soft tissue infections caused by susceptible organisms, although there are little data to recommend ofloxacin over ciprofloxacin for these indications. Ofloxacin should not be used alone to treat anaerobic or mixed aerobic/anaerobic infections, and a penicillin or cephalosporin is preferred for known or suspected streptococcal or pneumococcal infection. Ofloxacin is the only quinolone currently approved for the treatment of uncomplicated gonorrhea. It also is effective therapy for nongonococcal urethritis, although the tetracyclines are much less expensive. Ofloxacin has a good safety profile, but, as with other fluoroquinolones, it should not be used in children or in pregnant or nursing women. Further comparative trials may broaden the range of infections that can be treated with ofloxacin.

  7. Contribution of N-Nitrosamines and Their Precursors to Domestic Sewage by Greywaters and Blackwaters. (United States)

    Zeng, Teng; Mitch, William A


    N-nitrosamines and their precursors are significant concerns for water utilities exploiting wastewater-impacted water supplies, particularly those practicing potable reuse of wastewater. Previous efforts to identify specific precursors in municipal wastewater accounting for N-nitrosamine formation have met with limited success. As an alternative, we quantified the relative importance of greywater (i.e., shower, kitchen sink, bathroom washbasin, and laundry) and blackwater (i.e., urine and feces) streams in terms of their loadings of ambient specific and total N-nitrosamines and chloramine-reactive and ozone-reactive N-nitrosamine precursors to domestic sewage. Accounting for the volume fractions of individual greywater and blackwater streams, laundry water represented the most significant source of N-nitrosamines and their precursors, followed by shower water and urine. Laundry water was particularly important for ozone-reactive N-nitrosamine precursors, accounting for ∼99% of N-nitrosodimethylamine (NDMA) precursors and ∼69% of precursors for other uncharacterized N-nitrosamines. For the other greywater streams, consumer products contributed additional N-nitrosamines and precursors, but the remarkable uniformity across different products suggested the importance of common macroconstituents. The consumption of a standard dose of the antacid ranitidine substantially increased NDMA and its chloramine-reactive precursors in urine. Nevertheless, nearly 40% of the American population would need to consume ranitidine daily to match the NDMA loadings from laundry water.

  8. [Pharmaco-economic analysis of NSAID usage in Gastroenterology Department of Tuzla Clinic]. (United States)

    Skrbo, Armin; Sober, Miroslav; Skrbo, Selma; Omerhodzić, Alma; Zunić, Lejla


    Pharmacoeconomics is young rapidly developing science that uses economic, clinical and epidemiologic methods. It studies adequate use of therapeutics giving guidelines towards rational utilization of the resources in health care. Pharmacoeconomics indentifies estimates and compares costs and clinical outcomes of different strategies giving the best solution: optimal cost/benefit ratio. These studies can be used to estimate existing programs and plan the new ones. The aim of this paper was to carry out pharmacoeconomic study on the non-steroid anti-inflamatory drugs (NSAID) use in canton Tuzla, to compare costs of medication with highly selective cyclooxygenase 2 (COX-2) inhibitors and nonselective NSAIDs and to calculate medication costs of the bleeding from upper parts of gastrointestinal tract. Study covers period from January to April 2004. Meta-analysis of selected clinical studies on safe and efficiency of NSAIDs was simultaneously conducted. Our results show that hospital treatment costs of the high-risk patients group significantly exceeds their potential medication costs with highly selective COX-2 inhibitors. Simultaneous use of non-selective NSAIDs with antacids has justification only in the low-risk group with mild gastrointestinal disturbances.

  9. Risk factors associated with the development of gastroduodenal ulcers due to the use of NSAIDs. (United States)

    Wolfe, M Michael


    The risk of gastrointestinal mucosal injury with non-steroidal anti-inflammatory drugs (NSAIDs) is dose-dependent. Epidemiological studies have clearly demonstrated a rank order of risk of ulcer complications for commonly used NSAIDs, with ibuprofen consistently associated with the lowest risk and piroxicam with the highest. Antacids, H2 receptor antagonists and misoprostol all have drawbacks as prophylaxis. Of the cyclo-oxygenase (COX)-2 selective NSAIDs, rofecoxib is associated with a lower risk of gastrointestinal toxicity but there is uncertainty about the long-term risk associated with celecoxib. Rofecoxib has been associated with a significantly higher incidence of myocardial infarction than naproxen that may counteract the benefit of greater gastrointestinal safety. At over-the-counter doses, the short duration of use and the low dose reduce the risk of a serious adverse event compared with chronic use at prescribed doses. Intermittent therapy with low-dose NSAIDs has proved extremely safe and it has not been determined whether COX-2 selective agents offer a safety advantage compared with such treatment.

  10. A study on concept of P- drug selection among rural general practitioners

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    Priyadarshini Bai G.


    Full Text Available Background: The objective of the study was to assess the awareness of P- drug selection among rural general practitioners’s (GP for common medical conditions. Methods: Fifty general practitioners in Tumakuru district were provided with proformas for selection of P- drugs for mild to moderate hypertension, diabetes, upper respiratory tract infections and acid peptic disease based on safety, affordability, need, and efficacy (SANE criteria. Results: Forty one GP’s responded by completing the proformas. Seventeen of them were aware of the concept of P- drug selection. In hypertension, beta blockers followed by Angiotensin Converting Enzyme (ACE inhibitors were most commonly preferred. In diabetes, biguanides followed by sulfonylureas were preferred as oral hypoglycemic agents. Ampicillin, Ciprofloxacin and Cotrimoxazole were the commonly used antibiotics for upper respiratory tract infections. Ranitidine and antacids were preferred for acid peptic disease. Affordability followed by efficacy was the deciding criteria for P- drug selection. Conclusions: There is lack of awareness of P- drug selection among many rural GP’s. Therefore, there is necessity to create awareness about P- drug selection through continued medical education for rational use of drugs.

  11. Diagnosis and treatment of gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Raul; Badillo; Dawn; Francis


    Gastroesophageal reflux disease(GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical,atypi-cal and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms,these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations,further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis,peptic stricture,Barrett’s esophagus,esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification,medical therapy and surgical therapy. Life-style modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids,histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy,others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gas-troesophageal reflux disease.

  12. Analysis of related factors in the development of chronic gastritis to gastric cancer%影响慢性胃炎发展为胃癌的相关因素分析

    Institute of Scientific and Technical Information of China (English)



    Objective To study the related factors in the development of chronic gastritis to gastric cancer, and to explore effective preventive measures. Methods Ninety-two patients with chronic gastritis and gastric cancer in our hospital from November 2011 to November 2014 were selected as observation group. And 92 patients who were diag-nosed with only chronic gastritis by gastroscope and pathological examination during the same period were selected as control group. The influence factors in the development of chronic gastritis to gastric cancer were analyzed by single factor analysis and logistic regression analysis. Results The related factors included pickles, hot food, mildew foods, fried foods, smoking, drinking, breakfast, diet, daily salt intake, intermittent use of acid and antacid drugs, history of digestive disease (P<0.05). Taking the above factors into logistic multivariate regression analysis, the result showed that pickles, mildew food, fried food, irregular diet, a history of digestive disease were risk factors in the development of chronic gastritis to gastric cancer, and that continuous use of acid and antacid drugs were protection factors (P<0.05). Conclusion The development of chronic gastritis to gastritis cancer is mainly related to eating habits, history of diges-tive disease. Good diet can reduce the risk of cancer in patients with chronic gastritis.%目的:研究慢性胃炎发展为胃癌的影响因素,探讨有效的预防措施。方法选择2011年11月至2014年11月在我院接受治疗的慢性胃炎合并胃癌患者92例作为观察组。选取同期经胃镜和病理学检查确诊为慢性胃炎的患者92例作为对照组。用单因素分析和Logistic回归分析慢性胃炎发展为胃癌的影响因素。结果慢性胃炎发展为胃癌与腌菜、烫食、霉变食品、油炸食品饮酒、吸烟、早餐、饮食规律、每日摄盐量、间断使用抑酸和制酸药物、消化道病史等因素有关(P<0.05)。将上

  13. In vitro studies on interactions of iron salts and complexes with food-stuffs and medicaments. (United States)

    Geisser, P


    It has been shown in the present study that food components such as phytic acid, oxalic acid, tannin, sodium alginate, choline and choline salts, vitamins A, D3 and E, soy oil and soy flour, do not undergo any interactions with iron(III)-hydroxide polymaltose complex (Ferrum Hausmann). Phytic acid, oxalic acid, tannin and sodium alginate, however, react with iron(II) or iron(III)-salts at pH values of 3.0, 5.5 and 8.0, giving rise to iron complexes. Trimethylamine-N-oxide, which is present in fish meal, reacts with iron(II)-sulphate to produce iron(III) reaction products; it does not react with iron(III)-hydroxide polymaltose complex. Special soybean flours show no irreversible adsorption or precipitation with iron(III)-hydroxyide polymaltose complex over the pH range 3.0-8.0, in contrast to iron(II)-sulphate. Antacids containing aluminium hydroxide, talc, ion exchange resins or other unabsorbable, insoluble components absorb iron(III)-hydroxide polymaltose complex in the pH range 3.0-8.0 in a reversible manner, while the strong adsorption or precipitation observed with iron(II)-sulphate at pH 8.0 is irreversible. No interaction was observed between the steroid hormones studied and iron(II)-sulphate or iron(III)-hydroxide polymaltose complex. On the basis of the measured compatibilities, iron(III)-hydroxide polymaltose complex can be administered orally simultaneously with many other drugs, without prejudicing the absorption of iron or of the other drug as is often seen with iron(II) and iron(III) salts.

  14. Improvement of clinical parameters in patients with gastroesophageal reflux disease after radiofrequency energy delivery

    Institute of Scientific and Technical Information of China (English)

    Hai-Feng Liu; Jian-Guo Zhang; Jun Li; Xiao-Guang Chen; Wei-An Wang


    AIM: To evaluate the efficacy of Stretta procedure with gastroesophageal reflux disease (GERD) based on symptom control, medication changes and oesophagitis grade.METHODS: Ninety patients with a history of GERD underwent Stretta procedure from June 2007 to March 2010. All patients with GERD diagnosed by the presence of endoscopically evidenced oesophagitis or abnormal esophageal pH testing. We evaluated GERD-health-related quality of life, satisfaction, medication use and endoscopy at baseline, 6, 12 mo after treatment. Complications of the procedure were analyzed. RESULTS: We found that patients experienced significant changes in symptoms of GERD after Stretta procedure. The onset of GERD symptom relief was less than 2 mo (70.0%) or 2 to 6 mo (16.7%). The mean GERD-HRQL score was 25.6 (baseline), 7.3 (6 mo, P< 0.01), and 8.1 (12 mo, P< 0.01).The mean heartburn score was 3.3 (baseline), and 1.2 (12 mo, P< 0.05). The percentage of patients with satisfactory GERD control improved from 31.1% at baseline to 86.7% after treatment, and patient satisfaction improved from 1.4 at baseline to 4.0 at 12 mo (P< 0.01). Medication usage decreased significantly from 100% of patients on proton pump inhibitors therapy at baseline to 76.7% of patients showing elimination of medications or only as needed use of antacids/H2-RA at 12 mo. An improvement in endoscopic grade of oesophagitis was seen in 33 of the 41 patients. All patients had either no erosions or only mild erosive disease (grade A) at 6 mo. CONCLUSION: The experience with Stretta procedure confirms that it is well tolerated, safe, effective and durable in the treatment of GERD. The Stretta procedure provides the drug-refractory patients with a new minimally invasive method.

  15. Self-medication in academic course graduate of health in a private university of the state of Rio Grande do Sul

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    Thricy Dhamer


    Full Text Available Rationale and Objectives: The World Health Organization defi nes self-medication as the selection and use of medicines by individuals to treat their illnesses or symptoms. It is considered a public health problem that deserves special attention, since it presents risks, because of adverse drug reactions, bringing serious consequences and may lead to the death. To determine the prevalence and characteristics of self-medication realized by undergraduate students enrolled in health courses in a community college, as well the symptoms that led to this practice. Methods: This study was an observational and quantitative research, where it was used structured and pre-coded questionnaires to obtains the data, among students enrolled at 5th and 6th semesters of Biology, Physical Education, Nursing, Pharmacy, Physiotherapy, Medicine, Nutrition, Dentistry and Psychology at the University of Santa Cruz do Sul. Results: 342 students were evaluated, 74% female, aged between 18 and 50, which was the most prevalent age group of 21-30 years, which were 71.4% of students. The prevalence of medicines used among those surveyed was 68.7% last month, with an average of 2 medications per student. The medications were distributed by medical prescription in 282 cases (59.1%, under self-medication in 139 cases (29.1%, oriented by a pharmaceutical in 25 cases (5.2% and no response in 31 cases (6.6%. The classes of drugs most used were analgesics/antipyretics (48.2%, NSAIDs (14.2% and antacids (9.9%. The main purpose of motivating self medication were headache (14.4%, digestive disorders (13.2%, contraception (7.2% and general pain (6.0%. Conclusion: Self medication is a common practice among students in the health area, where about a third reported conduct such practice. KEYWORDS Self-medication. Student Health Occupations. Drugs.

  16. Are proton pump inhibitors associated with the development of community-acquired pneumonia? A meta-analysis. (United States)

    Giuliano, Christopher; Wilhelm, Sheila M; Kale-Pradhan, Pramodini B


    This study was presented at the American College of Chest Physicians meeting in Pittsburgh (PA, USA) in October 2011. The study objective was to evaluate the association of proton pump inhibitors (PPIs) and community-acquired pneumonia (CAP). The design was a meta-analysis of nine case-controlled and cohort studies. 120,863 pneumonia cases from 1987 to 2006 were included in the meta-analysis. PubMed and Ovid Medline were searched from inception through May 2011 by two investigators independently using keywords: PPI, pneumonia, CAP, anti-ulcer, antacid, omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole. This meta-analysis only included case-controlled and cohort studies that were published in full in English and evaluated PPI use and CAP incidence. Studies were excluded if they included the following patients: pediatric, Helicobacter pylori treatment and critically ill. Bibliographies of recent review articles and systematic reviews were hand-searched. Quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Two investigators independently extracted data into standardized data collection forms that were confirmed by a third investigator. Data were analyzed based on current use of PPIs, duration of PPI use (180 days) and PPI dose (high vs low). Overall association of PPI and CAP was analyzed using the random effects model (Comprehensive Meta analysis(®) Version 2.0). Nine studies met all criteria for the primary outcome. Newcastle-Ottawa Quality Assessment Scale scores ranged from 4 to 8 out of 9. Current use of PPIs (odds ratio [OR]: 1.39; 95% CI: 1.09-1.76), PPI use 180 days (OR: 1.10; 95% CI: 1.00-1.21). In conclusion, patients currently receiving PPIs, particularly <30 days or high dose, showed an association with CAP. Practitioners need to be vigilant about adverse effects of PPIs and consider alternative therapies.

  17. Towards safer and more predictable drug treatment--reflections from studies of the First BCPT Prize awardee. (United States)

    Neuvonen, Pertti J


    This MiniReview is a personal recollection of selected research topics, which the author in collaboration with colleagues has studied, aiming to improve the predictability of drug therapy. In early studies, we found bi- and trivalent cations to reduce the absorption of various tetracyclines and fluoroquinolones. Certain antacids elevated the bioavailability of some non-steroidal anti-inflammatory drugs and sulphonylureas. Various brands of phenytoin tablets revealed great differences in their bioavailability, causing clinical consequences. Numerous factors affecting the antidotal effect of activated charcoal were also studied, with charcoal compared to other gastrointestinal decontamination methods, including ipecac and gastric lavage. Effect of age and diseases on the pharmacokinetics of drugs was a research topic. Acute sotalol intoxications revealed its QT-prolonging properties, and even small mixed overdoses of moclobemide with serotonergic drugs proved fatal. Itraconazole and other potent inhibitors of CYP3A4 could drastically increase exposure to drugs like midazolam, triazolam, buspirone, lovastatin, simvastatin and oxycodone, whereas rifampicin greatly reduced their plasma concentrations. A change from potent inhibition to induction caused a 400-fold change in the exposure to oral midazolam. CYP2C8 was revealed to be crucial in the metabolism and interactions of several drugs. Many interactions affecting statins are CYP3A4-mediated, but transporters are important in certain interactions. Tizanidine is very susceptible to CYP1A2 inhibition. Fruit juices such as grapefruit juice can raise or lower exposure to different drugs. Both drug interactions and pharmacogenetics can modify the activity of cell membrane transporters and cause variability in the pharmacokinetics of and response to their substrate drugs.

  18. Acid-Base Buffering Properties of Five Legumes and Selected Food in vitro

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    Maher M. Al-Dabbas


    Full Text Available Problem statement: in vitro acid-Buffering Capacity (BC values of 5% (dry matter aqueous homogenized suspension of five legumes (broad bean, lentils, chickpea, kidney bean and lupine and of selected antacid home preparations (cow's milk, almond, peanut, licorice, carob and lettuce stem were investigated within and among samples from their respective initial pH until pH was decreased to 1.5. BC was the highest for cow's milk, carob, licorice and lettuce stem (BC values 1.65-1.97, intermediate for almond and peanut (BC values, 1.37-1.64 and the lowest for selected legumes (0.84-1.36. Approach: The purpose of this study was to measure in vitro the buffering capacity potential of legumes and other foods commonly used in Jordan as heartburn remedies to determine the ability of these products to de-acidify, neutralize acid, or increase pH levels of an acid and a base solution. Results: BC of the studied legumes showed positive and strong correlations, with protein, aspartic and glutamic amino acids contents (R = 0.95, 0.94, 0.89, respectively and relatively weak correlation with phosphorus content (R = 0.38. Conclusion/Recommendations: The differences in BC within and among studied samples were largely due to the differences in their chemical compositions. Protein, fiber, ash, organic acids and aspartic and glutamic acids contents and alkalinity of ashes showed significant BC, while high fat content in almond and peanut failed to show considerable BC.

  19. Intern’s knowledge of clinical pharmacology and therapeutics at Puducherry: a cross-sectional study

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    Nitya S


    Full Text Available Background: Internship is the intermediate period between under-graduation and general practice. The dexterity of health professional relies upon prescribing practices. Clinical pharmacology and therapeutics (CPT is a crucial discipline for interns to acquire safe and rational prescription of drugs. Cultivating sound knowledge about CPT during under graduation is, henceforth, mandatory. Aims and objectives: 1.To assess whether the undergraduate CPT teaching and internship training had prepared interns adequately for safe and rational prescription. 2.To assess the awareness and reporting of adverse drug reaction (ADR. Methods: 110 interns were enrolled after obtaining informed written consent. A structured questionnaire was given to them including basic demographic information, undergraduate CPT teaching, experience of ADR and any deficiency in the under-graduate CPT teaching. Results: Response rate was 91 % in which 53 were males and 47 females. 81 considered themselves aware of CPT. 56% & 57% interns were able to prescribe drug safely and rationally respectively. Without supervision, they were confident to prescribe antacids (93%, vitamins and minerals (90%, NSAIDS (85%, antihistamines (82%, antibiotics (75%, antiemetics (62% and antiasthmatics (52%. Only 22% had reported ADR and opined that it could lead to hospitalization (51%, prolonged hospital stay (33%, morbidity (16% and death (21%. According to interns, the topics where more emphasis needed were ADR, dosage calculation, pediatric and emergency medicine and therapeutic drug monitoring during undergraduate CPT teaching. Conclusion: CPT teaching should be improved at undergraduate level for safe and rational prescribing including ADR monitoring, ADR reporting and dosage calculation. [Int J Basic Clin Pharmacol 2013; 2(5.000: 622-628

  20. A multicenter, double-blind, randomized, placebo-controlled comparison of nocturnal roxatidine in the treatment of active duodenal ulcer disease. Multicenter Roxatidine Cooperative Study Group. (United States)

    Gilinsky, N H; Bright-Asare, P; Cobert, B L; Fitch, D D; Lanza, F L; Kerr, R M; Savitsky, J P


    This multicenter randomized, double-blind, 4-wk study compared the new H2-receptor antagonistic roxatidine (R) to placebo (P) for treatment of endoscopically diagnosed active duodenal ulcer disease. Subjects were evaluated after 2 and 4 wk of treatment. Those whose ulcer was unhealed at 2 wk received 2 more weeks of treatment before final evaluation. Ulcer healing (endoscopically determined) with roxatidine was more effective than placebo at both wk 0-2 (R = 33.9%, P = 21.9%, p = 0.018) and wk 2-4 (R = 68.2%, P = 29.7%, p less than 0.001), with an overall 4-wk effectiveness of 78.9% compared to 44.8% (p less than 0.001). At the end of treatment, average maximum ulcer diameter diminished 83% in R and 50% in P (p less than 0.001). Roxatidine was also more effective than placebo in decreasing abdominal pain (p less than 0.001), decreasing the number of antacid tablets taken for pain relief (p less than 0.001), improving dyspeptic symptoms (p less than 0.001), and permitting return to a normal routine for subjects with previous illness-imposed restrictions on work and/or other daily activities. The profile of laboratory values and adverse experiences demonstrated roxatidine to be safe and well-tolerated. The efficacy of roxatidine as evaluated by the healing rate of duodenal ulcer and reduction in abdominal pain emphasize its value as an addition to the family of H2-receptor antagonists.

  1. 奥美拉唑胶囊的制备及质量控制

    Institute of Scientific and Technical Information of China (English)



    Objective:Preparation of omeprazole capsules analysis and quality control methods. Meth-ods:antacid sodium bicarbonate was added,its content using high performance liquid chromatography to detect. Results:The concentration of omeprazole in the(4-16)ug / mL,the good linear relationship between peak area;RSD were 100 . 35% and 0 . 56%;content of three batches of samples were 99 . 8%, 99. 4%,and 99. 8%. Conclusion:The preparation method is simple,accurate determination of the re-covery precise,contribute to the quality control of omeprazole,worthy of promotion.%目的:分析奥美拉唑胶囊的制备方法及其质量控制方法。方法:制备中加入抗酸剂碳酸氢钠,采用高效液相色谱对其含量进行检测。结果:奥美拉唑的质量浓度在(4-16)ug/mL之内,与峰面积线性关系良好;RSD分别为100.35%和0.56%;3批样品的含量分别为99.8%、99.4%和99.8%。结论:该制备法操作简单、测定精准、回收率精确,有助于对奥美拉唑的质量控制,值得在临床推广。


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    Kesley Elsa


    Full Text Available BACKGROUND Self-medication can be defined as obtaining and consuming drugs without the advice of a physician. There is a lot of public and professional concern about the irrational use of drugs in Self Medication. Even if self-medication helps in reducing the burden on the health care system to a certain extent, it can lead to severe problems like antimicrobial resistance and addictions. This study will provide useful insight on the reasons for which patients resort to this practice and might help the policy makers and regulatory authorities to streamline the process of drug regulations and safety issues of over-the-counter drugs. This study also focuses on the attitude of people, who follow the practice of self-medication. Self-medication in modern pharmaceuticals seems to be a field in which information is scarce and to the best of our knowledge there is limited research conducted to reveal the extent of this problem in our community. OBJECTIVE To find out the prevalence of self-medication among housewives and to study the associated factors in rural areas of Ernakulum district. METHODOLOGY The rural areas selected for the study was the field areas of MOSC Medical College, Kolencherry; 163 subjects were studied (With P=71% from a study conducted on self-medication practices in coastal regions of South India. 1 . Cluster sampling was used to select subjects and data was collected using pretested interviewer administered questionnaire from those who signed the informed written consent. Data was entered using EPI INFO software and analysis was done using appropriate statistical tools. (Prevalence, probabilities, confidence limits were calculated. RESULTS AND CONCLUSIONS The prevalence of self-medication among housewives was 57.67% and included analgesics (81.9%, antacids (31.91% and antibiotics were only used by 4.26%.

  3. Drug-induced diarrhoea. (United States)

    Chassany, O; Michaux, A; Bergmann, J F


    Diarrhoea is a relatively frequent adverse event, accounting for about 7% of all drug adverse effects. More than 700 drugs have been implicated in causing diarrhoea; those most frequently involved are antimicrobials, laxatives, magnesium-containing antacids, lactose- or sorbitol-containing products, nonsteroidal anti-inflammatory drugs, prostaglandins, colchicine, antineoplastics, antiarrhythmic drugs and cholinergic agents. Certain new drugs are likely to induce diarrhoea because of their pharmacodynamic properties; examples include anthraquinone-related agents, alpha-glucosidase inhibitors, lipase inhibitors and cholinesterase inhibitors. Antimicrobials are responsible for 25% of drug-induced diarrhoea. The disease spectrum of antimicrobial-associated diarrhoea ranges from benign diarrhoea to pseudomembranous colitis. Several pathophysiological mechanisms are involved in drug-induced diarrhoea: osmotic diarrhoea, secretory diarrhoea, shortened transit time, exudative diarrhoea and protein-losing enteropathy, and malabsorption or maldigestion of fat and carbohydrates. Often 2 or more mechanisms are present simultaneously. In clinical practice, 2 major types of diarrhoea are seen: acute diarrhoea, which usually appears during the first few days of treatment, and chronic diarrhoea, lasting more than 3 or 4 weeks and which can appear a long time after the start of drug therapy. Both can be severe and poorly tolerated. In a patient presenting with diarrhoea, the medical history is very important, especially the drug history, as it can suggest a diagnosis of drug-induced diarrhoea and thereby avoid multiple diagnostic tests. The clinical examination should cover severity criteria such as fever, rectal emission of blood and mucus, dehydration and bodyweight loss. Establishing a relationship between drug consumption and diarrhoea or colitis can be difficult when the time elapsed between the start of the drug and the onset of symptoms is long, sometimes up to several

  4. Sporadic salmonellosis in Lower Saxony, Germany, 2011-2013: raw ground pork consumption is associated with Salmonella Typhimurium infections and foreign travel with Salmonella Enteritidis infections. (United States)

    Rettenbacher-Riefler, S; Ziehm, D; Kreienbrock, L; Campe, A; Pulz, M; Dreesman, J


    To investigate risk factors for sporadic salmonellosis, for each notified case four randomly selected population controls matched for age, sex and geographical region were interviewed via self-administered questionnaire. Conditional logistic regression analysis of 285 matched pairs revealed significant associations for raw ground pork consumption [odds ratio (OR) 6·0, 95% confidence interval (CI) 1·8-20·1], taking antacids (OR 5·8, 95% CI 1·4-24·5), eating meat outside the home (OR 5·7, 95% CI 2·2-14·6) and daily changing or cleaning of dishcloth (OR 2·1, 95% CI 1·2-3·9). Animal contact and ice cream consumption were negatively associated with salmonellosis (OR 0·5, 95% CI 0·2-1 and OR 0·3, 95% CI 0·1-0·6, respectively). S. Typhimurium infections were significantly associated with raw ground pork consumption (OR 16·7, 95% CI 1·4-194·4) and S. Enteritidis infections with having travelled abroad (OR 9·7, 95% CI 2·0-47·3). Raw egg consumption was not a risk factor, substantiating the success of recently implemented national control programmes in the poultry industry. Unexpectedly, hygienic behaviour was more frequently reported by cases, probably because they overestimated their hygiene precautions retrospectively. Although animal contact might enhance human immunocompetence, underreporting of salmonellosis by pet owners could have occurred. Eating raw pork products is the major risk factor for sporadic human S. Typhimurium infections in Lower Saxony.

  5. In vitro and in vivo anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract. (United States)

    Cai, Jingmei; Kim, Tae-Su; Jang, Ja Young; Kim, Jihyun; Shin, Kyungha; Lee, Sung-Pyo; Choi, Ehn-Kyoung; Kim, Sa-Hyun; Park, Min; Kim, Jong Bae; Kim, Yun-Bae


    Effects of FEMY-R7, composed of fucoidan and evening primrose extract, on the bacterial growth and intragastric infection of Helicobacter pylori as well as gastric secretion were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1×10(8) CFU/mL) was incubated with a serially-diluted FEMY-R7 for 3 days. As a result, FEMY-R7 fully inhibited the bacterial growth at 100 µg/mL, which was determined to be a minimal inhibitory concentration. In addition, 6-hour incubation with H. pylori, FEMY-R7 inhibited urease activity in a concentration-dependent manner, showing a median inhibitory concentration of 1,500 µg/mL. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (5×10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10, 30 or 100 mg/kg FEMY-R7 for 7 days. In Campylobcter-like organism-detection test and bacterial identification, FEMY-R7 exerted a high bacteria-eliminating capacity at 30-100 mg/kg, comparably to 30 mg/kg pantoprazole. In contrast to a strong antacid activity of pantoprazole in a pylorus-ligation study, FEMY-R7 did not significantly affect gastric pH, free HCl, and total acidity, although it significantly decreased fluid volume at a low dose (10 mg/kg). The results indicate that FEMY-R7 eliminate H. pylori from gastric mucosa by directly killing the bacteria and preventing their adhesion and invasion, rather than by inhibiting gastric secretion or mucosal damage.

  6. Anti-ulcerogenic mechanism of magnesium in indomethacin induced gastric ulcer in rats. (United States)

    Adewoye, E O; Salami, A T


    The gastric mucosa is continuously exposed to various agents like food condiments, spices, alcohol, acids and drugs, some of which are implicated in the pathogenesis of gastric ulcer. Magnesium compounds commonly used as laxatives and antacids have been reported to prevent ulcer formation but the mechanisms underlying this potential is unknown. This study therefore seeks to evaluate the gastro-protective mechanism of magnesium in the stomach through its effect on the parietal and mucus cells. Thirty-six male albino rats divided into 6 groups of 6 rats each were used. Group 1 was control, Group 2 was ulcer induced and untreated, Group 3 was treated with 500mg/kg b.w magnesium alone, Group 4 was pre-treated with 500mg/kg b.w magnesium before inducing ulcer, Group 5 was pre-treated with 500mg/kg b.w magnesium and 20mg/kg omeprazole 4 hours before inducing ulcer, Group 6 was treated with 20mg/kg omeprazole 4 hours before inducing ulcer. Animals were sacrificed 6 hours after ulcer induction and their stomachs were removed for ulcer scoring and histological analysis. A significant reduction was observed in the ulcer scoring of magnesium pre-treated ulcerated rats (9.4±0.8) compared with ulcerated untreated (20.8±0.9) groups. Parietal cell count of magnesium pre treated ulcerated group significantly decreased (169.7±18.9) compared with ulcerated untreated group (310.5±34.7). Mucous cell count of magnesium pre-treated ulcerated group (264.6±8.3) significantly increased compared with ulcerated untreated group (170.0±17.7). This study shows that magnesium possesses anti-ulcerogenic properties due to its ability to reduce the number of parietal cell and increase mucous cell counts.

  7. Ebrotidine versus ranitidine in the treatment of acute duodenal ulcer. A multicentre, randomized, double-blind, controlled clinical trial. (United States)

    Matov, V; Metchkov, G; Krastev, Z; Tchernev, K; Mitova, R; Márquez, M; Torres, J; Herrero, E; Fillat, O; Ortiz, J A


    A total of 478 patients with endoscopically confirmed duodenal ulcer entered this randomized, parallel, double-blind trial. Patients were randomly assigned to receive ebrotidine (N-[(E)-[[2-[[[2-[(diaminomethylene)amino]- 4-thiazolyl]methyl]thio]ethyl]amino]methylene]-4-bromo-benzenesulfona mid e, CAS 100981-43-9, FI-3542) 400 mg or ranitidine 300 mg tablets (4:1) respectively, administered in single evening doses. Endoscopy, clinical examination and symptom assessment were performed at baseline and at weeks 4 and 8. Safety evaluations including laboratory tests, treatment compliance and antacid consumption checks were conducted at the beginning and/or at the 4 and 8 week visits. Patients whose ulcer showed endoscopic healing at the 4-week control left the study. Both groups were matched in all parameters studied. The healing rates at 4 weeks were 76.4% and 75.3% for ebrotidine and ranitidine respectively, while at 8 weeks the final rates were 95% and 91.8% respectively. Accompanying symptoms disappeared rapidly and the patients returned to normal. Smoking proved to be a highly significant negative risk factor, since healing rates were 83.4% and 71.2% at 4 weeks and 97.4% and 92.3% at 8 weeks in non-smokers and smokers respectively (p = 0.0046). Smokers treated with ranitidine showed significantly lower final healing rates than non-smokers (86% vs 100%; p = 0.0358), while the healing rates among patients treated with ebrotidine were similar regardless of whether they were smokers or not (93.9% and 96.7% N.S.). Ebrotidine (94%) proved to be more effective than ranitidine (86%) in smokers with higher healing rates (p < 0.05). Alcohol intake showed no significant relationship with the healing rates. Both drugs demonstrated an excellent safety. There were no changes in blood parameters, and no significant adverse events were reported.

  8. Perioperative fasting and children: A review article

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    Bahareh Imani


    Full Text Available This review provides an overview of the present knowledge on the aspects of preoperative fasting with the assessment of the evidence quality. A systematic research was conducted in electronic databases in order to identify trials published between 1990 and 2014 concerning preoperative fasting, early resumption of oral intake and the effects of oral carbohydrate mixtures on gastric emptying and postoperative recovery. The publications were classified in terms of their evidence level, scientific validity and clinical relevance. The key recommendations are that children be encouraged to drink clear fluids within up to 2 hours before elective surgery (including Caesarean section and all but one member of the guideline groups consider that tea or coffee, with milk added (up to about one fifth of the total volume, are still clear fluids .Furthermore, solid food consumption should be prohibited for up to 6 hours before elective surgery for children. However, patients should not have their operation cancelled or delayed only because they are chewing gums or sucking a boiled sweet immediately prior to the induction of anaesthesia. These recommendations also apply to those patients with obesity, gastro-oesophageal reflux and diabetes. There is insufficient evidence to support the routine use of antacids, metoclopramide or H2-receptor antagonists before elective surgery in non-obstetric patients. Infants should be fed before elective surgery. Breast milk is considered a safe option for up to 4 hours and other kinds of milk for up to 6 hours. The present review takes into account the safety and possible benefits of preoperative carbohydrates while offering advice on the postoperative resumption of oral intake.

  9. The hydrolytic products of aluminum and their biological significance. (United States)

    Bertsch, P M


    The relative distribution of Al between its various organic and inorganic complexes dictates its mobility in the environment, bioavailability, and toxicity. In recent years, there has been significant progress made in understanding the differential bioavailability and toxicity of various chemical species of Al to plants and certain aquatic organisms. Far less information concerning chemical speciation and differential uptake and transport of Al in humans is available. Among the important inorganic complexes of interest are the hydrolyzed-Al species, particularly the nonequilibrium, metastable polynuclear complexes, which form readily, have a fairly wide stability range, and have been demonstrated toxic to plants and fish. In recent years(27)Al NMR spectroscopy has provided significant direct information on the polynuclear complexes existing in a wide range of aqueous solutions. The [Al12O4(OH)24+n(H2O)12-n]((7-n)+) polynuclear complex is often found to be the predominant species in partially neutralized Al solutions and has recently been demonstrated to be more toxic to certain plants than the hexaaqua Al cation. It is also the principal component of Al-chlorohydrate, a highly soluble antiperspirant, present in many hydrolyzed Al solutions utilized in water and waste water treatment, and, as hypothesized herein, a primary constituent of many hydroxide gels utilized as antacids. This polynuclear has a wide pH stability range, reportedly forms copolynuclears with Si, and contains tetrahedrally coordinated Al within its structure, all features that may be relevant to the recently reported properties of Al associated with neuritic plaque cores.

  10. A prospective study of vitamin and mineral supplement use and the risk of upper gastrointestinal cancers.

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    Sonja P Dawsey

    Full Text Available We examined the association of use of multivitamins or single vitamin/mineral supplements with risk of four upper gastrointestinal cancers in the NIH-AARP Diet and Health Study cohort with 11 years of follow-up. After exclusions, 490,593 persons were included in our analytic cohort and 1780 upper gastrointestinal cancers were accrued. Hazard ratios (HRs and 95% confidence intervals (CIs were calculated using Cox models with adjustment for potential confounders. We observed no significant associations between multivitamin use and risk for the four cancer outcomes in crude or adjusted models. Among individual vitamin or mineral supplements, use of iron supplements was associated with significantly lower risk of esophageal adenocarcinoma (HR = 0.68, 95% CI = 0.49 to 0.94 and a significantly increased risk of gastric noncardia adenocarcinoma (HR = 1.59, 95% CI = 1.24 to 2.05. For gastric noncardia adenocarcinoma, we saw associations with zinc use (HR = 1.28, 95% CI = 1.01 to 1.62 and vitamin C use (HR = 0.79 95% CI = 0.65 to 0.96. Calcium use, some of which was reported as antacids and used to treat reflux disease, was associated with higher risk of esophageal adenocarcinoma (HR = 1.27, 95% CI = 1.06 to 1.52 and gastric cardia adenocarcinoma (HR = 1.27, 95% CI = 1.03 to 1.56 cancers. We saw no evidence that multivitamin use was associated with reduced risk of four highly fatal upper gastrointestinal cancers, but there were some differences in risk with reported use of individual supplements.

  11. Gastroesophageal reflux leads to esophageal cancer in a surgical model with mice

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    Chen Xiaoxin


    Full Text Available Abstract Background Esophago-gastroduodenal anastomosis with rats mimics the development of human Barrett's esophagus and esophageal adenocarcinoma by introducing mixed reflux of gastric and duodenal contents into the esophagus. However, use of this rat model for mechanistic and chemopreventive studies is limited due to lack of genetically modified rat strains. Therefore, a mouse model of esophageal adenocarcinoma is needed. Methods We performed reflux surgery on wild-type, p53A135V transgenic, and INK4a/Arf+/- mice of A/J strain. Some mice were also treated with omeprazole (1,400 ppm in diet, iron (50 mg/kg/m, i.p., or gastrectomy plus iron. Mouse esophagi were harvested at 20, 40 or 80 weeks after surgery for histopathological analysis. Results At week 20, we observed metaplasia in wild-type mice (5%, 1/20 and p53A135V mice (5.3%, 1/19. At week 40, metaplasia was found in wild-type mice (16.2%, 6/37, p53A135V mice (4.8%, 2/42, and wild-type mice also receiving gastrectomy and iron (6.7%, 1/15. Esophageal squamous cell carcinoma developed in INK4a/Arf+/- mice (7.1%, 1/14, and wild-type mice receiving gastrectomy and iron (21.4%, 3/14. Among 13 wild-type mice which were given iron from week 40 to 80, twelve (92.3% developed squamous cell carcinoma at week 80. None of these mice developed esophageal adenocarcinoma. Conclusion Surgically induced gastroesophageal reflux produced esophageal squamous cell carcinoma, but not esophageal adenocarcinoma, in mice. Dominant negative p53 mutation, heterozygous loss of INK4a/Arf, antacid treatment, iron supplementation, or gastrectomy failed to promote esophageal adenocarcinoma in these mice. Further studies are needed in order to develop a mouse model of esophageal adenocarcinoma.

  12. 255Gy irradiated tachyzoites of Toxoplasma gondii induce intestinal immune response in C57BL/6J immunized by oral route

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    Galisteo Junior, Andres Jimenez; Alves, Janaina Baptista [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil). Lab. de Biologia Molecular]. E-mail:; Hiramoto, Roberto Mitsuyoshi [Instituto Adolfo Lutz, Sao Paulo, SP (Brazil). Secao de Parasitoses Sistemicas]. E-mail:; Carmo, Claudia Villano do; Andrade Junior, Heitor Franco de [Instituto de Medicina Tropical de Sao Paulo, Sao Paulo, SP (Brazil). Lab. de Protozoologia]. E-mail:


    Toxoplasmosis, a prevalent widespread infection in man and animals, occurs mainly through ingestion of water and food contaminated with oocyst from cat feces, causing usually benign disease in humans, except in intrauterine fetal infection or in immunodeficient patients. We study the oral route for the development of a vaccine for toxoplasmosis, using parasites irradiated with 60 Cobalt, as an alternative for vaccine development to this worldwide parasitic infection. We evaluated the development of immunity at serum or mucosal levels, and their efficiency in protect the mice against challenge with oral cysts of the ME-49 strain. C57Bl/6j isogenic mice were immunized by oral route with 10{sup 7} 255 Gy irradiated tachyzoites from RH strain, at several protocols using milk as anti-peptic adjuvant and alum hydroxide as antacid. The preparations of irradiated tachyzoites induced production of serum IgG and IgA in immunized mice, as determined by ELISA, with IgG2a as the dominant subclass, similar to chronic infection. Their use with adjuvant allowed the excretion of significant amounts of IgA in stools also IgG, despite a lesser extent. All oral preparations induced some quantitative protection against challenge, which was similar to the parenteral route only isolated alum hydroxide was used as adjuvant. All these data support the possibility of the development of an oral vaccine against toxoplasmosis, using irradiated tachyzoites, which would be possible tool in near future for use in field baits, for immunizing either domestic or wild felids. (author)

  13. Aluminum, parathyroid hormone, and osteomalacia

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    Burnatowska-Hledin, M.A.; Kaiser, L.; Mayor, G.H.


    Aluminum exposure in man is unavoidable. The occurrence of dialysis dementia, vitamin D-resistant osteomalacia, and hypochromic microcytic anemia in dialysis patients underscores the potential for aluminum toxicity. Although exposure via dialysate and hyperalimentation leads to significant tissue aluminum accumulation, the ubiquitous occurrence of aluminum and the severe pathology associated with large aluminum burdens suggest that smaller exposures via the gastrointestinal tract and lungs could represent an important, though largely unrecognized, public health problem. It is clear that some aluminum absorption occurs with the ingestion of small amounts of aluminum in the diet and medicines, and even greater aluminum absorption is seen in individuals consuming large amounts of aluminum present in antacids. Aluminum absorption is enhanced in the presence of elevated circulating parathyroid hormone. In addition, elevated PTH leads to the preferential deposition of aluminum in brain and bone. Consequently, PTH is likely to be involved in the pathogenesis of toxicities in those organs. PTH excess also seems to lead to the deposition of aluminum in the parathyroid gland. The in vitro demonstration that aluminum inhibits parathyroid hormone release is consistent with the findings of a euparathyroid state in dialysis patients with aluminum related vitamin D-resistant osteomalacia. Nevertheless, it seems likely that hyperparathyroidism is at least initially involved in the pathogenesis of aluminum neurotoxicity and osteomalacia; the increases in tissue aluminum stores are followed by suppression of parathyroid hormone release, which is required for the evolution of osteomalacia. Impaired renal function is not a prerequisite for increased tissue aluminum burdens, nor for aluminum-related organ toxicity. Consequently, it is likely that these diseases will be observed in populations other than those with chronic renal disease.

  14. Role of dietary polyphenols in the management of peptic ulcer. (United States)

    Farzaei, Mohammad Hosein; Abdollahi, Mohammad; Rahimi, Roja


    Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.

  15. Effect of Vitamin C on adrenal suppression by etomidate induction in patients undergoing cardiac surgery: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Deepanwita Das


    Full Text Available Introduction: Etomidate is usually preferred in the induction of cardiac compromised patients due to its relative cardiovascular stability. However, the use of this drug has been limited as etomidate induces suppression of cortisol biosynthesis as a result of blockade of 11-beta-hydroxylation in the adrenal gland, mediated by the imidazole radical of etomidate. This study was carried out to observe the effect of Vitamin C on adrenal suppression after etomidate induction in patients undergoing cardiac surgery. Materials and Methods: A total of 78 patients were randomly distributed into two groups. Group-I received oral Vitamin C (500 mg twice daily and Group-II received antacid tablet as placebo twice daily instead of Vitamin C for 7 consecutive days prior to surgery till morning of surgery. Patients of both the groups induced with etomidate (0.1-0.3 mg/kg. Blood cortisol was estimated at different points of time till 24 th postinduction hour/blood lactate, glucose, hemodynamic parameters, and perioperative outcomes were assessed. Results: Data of seventy patients (n = 35 in each group were finally analyzed. Cortisol level is statistically significantly higher in Group-I (69.51 ± 7.65 as compared to Group-II (27.74 ± 4.72 (P < 0.05 in the 1 st postinduction hour. In Group-II, cortisol was consistently lower for 1 st 24 postinduction hour. Total adrenaline requirement was statistically significantly high in Group-II. Time of extubation, length of Intensive Care Unit stay arrhythmia was similar in both the groups. Conclusion: Vitamin C effectively inhibits etomidate-induced adrenal suppression in cardiac patients, thereby etomidate can be used as a safe alternative for induction in cardiac surgery under cardiopulmonary bypass when pretreated with Vitamin C.

  16. A low cost method to produce a gaseous environment for the isolation of Helicobacter pylori Un método de bajo costo para producir el ambiente gaseoso para el aislamiento de Helicobacter pylori

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    Francisco Hernández


    Full Text Available A low cost method (LCM to produce a gaseous environment for the isolation of Helicobacter pylori, was compared with the standard Gas Park system. The LCM uses a carbonated antacid tablet, a plastic bag with tap water, a candle, and a wide-mouthed glass jar provided with a tight-fitting metalic screw cap and a rubber gasket. Antral gastric biopsies from 153 cases were incubated by duplicate on blood agar plates and treated with the two methods. In 95 cases the agent was isolated from both, and only from the standard method in 10 cases; the opposite condition was found in five cases, and 43 were negative. That difference is not significant (Pearson's X²= 93.25 p > 0,05Se comparó un método de bajo costo (MBC para producir el ambiente gaseoso para el aislamiento de Helicobacter pylori, con el sistema estándar de gas Pak. El MBC usa una tableta carbonata de antiácido, una bolsa plástica con agua, una candela y un frasco de vidrio con boca ancha, provisto de tapa metálica de rosca con empaque de hule. Las biopsias de antro de 153 pacientes se inocularon por duplicado en platos de agar sangre y se incubaron bajo los dos sistemas. En 195 casos el agente se aisló de ambos platos, y sólo del incubado bajo el método estándar en diez casos; la condición opuesta se presentó en cinco casos; 43 casos fueron negativos. Esa diferencia no es significativa (X² de Pearson = 93,25 p > 0,05

  17. Treating gastro-oesophageal reflux disease during pregnancy and lactation: what are the safest therapy options? (United States)

    Broussard, C N; Richter, J E


    Gastro-oesophageal reflux and heartburn are reported by 45 to 85% of women during pregnancy. Typically, the heartburn of pregnancy is new onset and is precipitated by the hormonal effects of estrogen and progesterone on lower oesophageal sphincter function. In mild cases, the patient should be reassured that reflux is commonly encountered during a normal pregnancy: lifestyle and dietary modifications may be all that are required. In a pregnant woman with moderate to severe reflux symptoms, the physician must discuss with the patient the benefits versus the risks of using drug therapy. Medications used for treating gastro-oesophageal reflux are not routinely or vigorously tested in randomised, controlled trials in women who are pregnant because of ethical and medico-legal concerns. Safety data are based on animal studies, human case reports and cohort studies as offered by physicians, pharmaceutical companies and regulatory authorities. If drug therapy is required, first-line therapy should consist of nonsystemically absorbed medications, including antacids or sucralfate, which offer little, if any, risk to the fetus. Systemic therapy with histamine H2 receptor antagonists (avoiding nizatidine) or prokinetic drugs (metoclopramide, cisapride) should be reserved for patients with more severe symptoms. Proton pump inhibitors are not recommended during pregnancy except for severe intractable cases of gastrooesophageal reflux or possibly prior to anaesthesia during labour and delivery. In these rare situations, animal teratogenicity studies suggests that lansoprazole may be the best choice. Use of the least possible amount of systemic drug needed to ameliorate the patient's symptoms is clearly the best for therapy. If reflux symptoms are intractable or atypical, endoscopy can safely be performed with conscious sedation and careful monitoring the mother and fetus.

  18. Imprudent Gastro-protective Approach in Majority of Specialists’ Clinics of a Tertiary Hospital (United States)

    Patel, Hardik Rameshbhai


    Introduction One out of four prescriptions in out-patient departments contains a gastro-protective drug (APUD) - PPI/ H2 Blockers/ Antacids/ Ulcer Protective’s. These drugs should be prescribed only when there is a justified indication. To assess the prescriptions of gastro-protective agents for appropriateness and rationality, in a tertiary care hospital setup. Materials and Methods It was a cross-sectional observational study conducted from Aug 2013 to Dec 2013 at OPDs of a Tertiary Care Teaching Hospital, Pune. A total of 260 prescriptions containing gastro-protective agents were analysed for appropriateness and rationality. Rationality of drug use was assessed by referring to standard textbooks and guidelines. Cost difference data was analysed by Wilcoxon signed rank test using GraphPad Prism 6. Results Most common class of gastro-protective agents was Proton pump inhibitors (PPIs)-73.77% (Pantoprazole & Dexrabeprazole). Only 37.3% prescriptions had an adequate indication for these drugs {GI prophylaxis (29.6%) and Acid Peptic Disease treatment (7.7%)}. Two irrational Fixed dose combinations found in the study were PPI with prokinetic agent (n=65) and Proton Pump Inhibitor + NSAID combination (n=2). Formulation, spelling and strength errors were found with 75 prescribed drugs. Medication instructions were lacking with most of the drugs. Drug interactions with co-prescribed drugs could be anticipated in 79 cases. Injudicious use of anti-peptic ulcer agents significantly increased the cost of prescriptions (p<0.0001). Conclusion Anti-ulcer drugs are overenthusiastically prescribed by all specialties which can predispose to adverse effects, drug interactions, increased cost and even erroneous prescriptions. PMID:27134889

  19. Evaluation of stress hormones in traumatic brain injury patients with gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Biteghe-Bi-Nzeng Alain-Pascal; WEI Hui-jie; CHEN Xin; ZHANG Jian-ning


    Objective:To evaluate the local risk factors of traumatic brain injury(TBI)patients developing gastrointestinal(GI)bleeding during the early hospitalization in neurosurgery intensive care unit(NICU).Method:From September 2005 to February 2006,41 patients admitted to NICU and 13 healthy volunteers were involved in our study.Blood samples at 24 hours,2-3 days and 5-7 days were obtained from each patient via arterial line at 8 measure the concentrations of serum adrenocorticotropic hormone(ACTH),total cortisol and gastrin.The collected serum was immersed in an ice bath and tested by the Immulite 1000 systems.Data were analyzed by SPSS 11.5.Results:Within 24 hours following TBI,the concentrations of total cortisol,ACTH and gastrin increased proportionally to the severity of injury,especially significant in the experimental group(P<0.05).The concentrations of ACTH and gastrin were higher in the GI bleeding positive group than in the GI bleeding negative group,(F=1.413,P=0.253)for ACTH and(F=9.371,P=0.006)for gastrin.GI bleeding had a positive correlation with gastrin concentration(r=0.312,P<0.05)and a negative correlation with serum hemoglobin(Hb)(r=-0.420,P<0.01).The clinical incidence of GI bleeding was 24.39%(10/41)in the experimental group.Within 24 hours,GI bleeding had a strong correlation with gastrin concentration(OR=26.643,P<0.05)and hematocrit(Hct)(OR=5.385,P<0.05).High ACTH concentration(>100 pg/ml)increased the frequency of GI bleeding.For patients with severe TBI and treated with routine antacids,the incidence of GI bleeding was 40.91%(9/22)and the mortality rate was 20%(2/10).Conclusions:Low Glasgow coma scale scores,low Hb,high concentrations of gastrin and ACTH(>100 pg/ml)are risk factors and can be predictive values for post-traumatic GI bleeding.Severe TBI patients have high risks of GI bleeding with high mortality.

  20. Analysis of Drug Use in the Gout Database and the Life Quality of Patients during 2013-2014%2013年至2014年医院痛风患者用药情况与生活质量分析

    Institute of Scientific and Technical Information of China (English)

    刘红; 肖纯; 蒲佳; 刘丹; 杨静; 邓代华; 李敏


    目的 探讨医院痛风数据库中常用药物使用情况并分析患者生活质量,为临床治疗提供参考.方法 利用医院痛风数据库收集患者资料,选取医院2013年11月至2014年11月住院接受抗痛风药物治疗的340例痛风患者,统计并分析其抗痛风类药物的用药情况,用药频度(DDDs)、排序,以及其他分类药品非甾体抗炎药、激素类药、抗酸药在痛风各分期的使用分布情况;统计并分析患者治疗前及治疗后(出院时)视觉模拟评分(VAS)、健康相关生活质量量表(HRQOL)评分情况.结果 抗痛风类药使用中,秋水仙素DDDs最高,使用率达85. 29%,高于其他药物的使用率( P0. 05),在间隔期、慢性期、缓解期的使用率均高于其他分类药物( P 0. 05 );in the interval, the chronic phase, the remission period of the use rate were higher than other drugs ( P < 0. 05 ); through the treatment, the patient's pain score and life quality score were significantly improved. After treatment, the percentage of patients with severe pain was reduced by 37. 06%, the quality of life score reached 27. 16%( P < 0. 01 ) . Conclusion The treatment of gout disease by colchicine combined with non-steroidal anti-inflammatory drugs are used as the first-line treatment of acute exacerbation, and in chronic phase and remission stage, the main application of acid and acid in-hibitor are appllied. Sodium bicarbonate as antacids is used in various stages for symptomatic treatment. The drug use is reasonable, the clinical curative effect is good, the life quality of the patient improves obviously.

  1. Uso de medicamentos como fator de risco para fratura grave decorrente de queda em idosos Medication as a risk factor for falls resulting in severe fractures in the elderly

    Directory of Open Access Journals (Sweden)

    Evandro da Silva Freire Coutinho


    Full Text Available Quedas seguidas de fraturas entre idosos constituem um importante problema de saúde pública. Um estudo caso-controle foi conduzido para avaliar o papel do uso de um conjunto de medicamentos, como fator de risco para esses acidentes entre pessoas com 60 anos ou mais, na cidade do Rio de Janeiro, Brasil. Cento e sessenta e nove casos de internação por fratura conseqüente a queda, e 315 controles hospitalares foram pareados por idade, sexo e hospital. Odds ratios (OR, ajustados por fatores potenciais de confusão, foram obtidos utilizando-se regressão logística condicional. Observou-se um aumento no risco desses acidentes para o uso de drogas bloqueadoras dos canais de cálcio (OR = 1,96, 1,16-3,30 e benzodiazepínicos (OR = 2,09, 1,08-4,05, e uma redução para o uso de diuréticos (OR = 0,40, 0,20-0,80. Antiácidos, digitálicos e laxantes mostraram-se associados a uma redução do risco de fraturas por quedas, cuja significância estatística atingiu níveis limítrofes (0,05 Falls leading to fractures among the elderly are a major public problem. A case-control study was conducted on the use of certain drugs as a risk factor for hospitalization due to fractures after falls among individuals aged 60 years or over in the city of Rio de Janeiro, Brazil. One hundred sixty-nine cases and 315 in-patient controls were matched by age, sex, and hospital. Odds ratios (OR adjusted for potential confounders were calculated using conditional logistic regression. Increased risk of such accidents was found for calcium channel antagonists (OR = 1.96, 1.16-3.30 and benzodiazepines (OR = 2.09, 1.08-4.05, and decreased risk was associated with diuretics (OR = 0.40, 0.20-0.80. Antacids, digitalis, and laxatives were associated with reduced risk of fractures after falls that reached borderline statistical significance (0.05 < p < 0.10. The findings highlight the need to weigh risks and benefits of medication in the elderly. It is also important to advise

  2. Clinical Study of Oropharyngeal Bacterial Colonization in Neurosurgical Patients with Tracheotomy%神经外科气管切开患者口咽部细菌定植的临床研究

    Institute of Scientific and Technical Information of China (English)

    巢少辉; 朱晓琳; 毛剑; 金建辉


    Objective: To investigate oropharyngeal bacterial colonization in neurosurgical patients with tracheotomy and influencing factors. Method: Selected 51 patients with tracheotomy in neurosurgery, on the first day, third day and 7th day after tracheotomy, sputum samples were collected and bacteria were cultured. Compared the number of patients whose bacteria were detected, respiratory tract were infected, and analyzed the influential factors. Result: Respiratory infection cases and bacterial detected cases on the 7th days after tracheotomy were significantly more than the cases on the first day(P <0.05) . Disease severity, decreased resistance, catheter retention time, mechanical ventilation, antacids, nutrition in the gastrointestinal, analgesics, antibiotics, which were statistically significant on single factor analysis (P<0.05) , disease severity, decreased resistance, catheter retention time, which were statistically significant on multivariate a-nalysis(P<0. 05). Conclusion: In order to reduce respiratory infections and bacterial colonization on patients with tracheotomy, catheter retention time should be shorten.%目的:探讨神经外科气管切开患者口咽部细菌定植及影响因素研究.方法:选择神经外科行气管切开患者共51例,术后1、3、7d采集痰标本进行细菌培养,比较定植菌检出例数,呼吸道感染例数,分析影响因素.结果:呼吸道感染例数、检出定植菌例数第7天比第1天多,差异具有显著性,P<0.05.疾病严重程度、抵抗力下降、置管时间、机械通气、止酸剂、胃肠内营养、镇痛药、抗生素在单因素分析后的结果具有统计学意义,P<0.05.疾病严重程度、抵抗力下降、置管时间在多因素分析后的结果具有统计学意义,P<0.05.结论:为了控制气管切开患者细菌定植和呼吸道感染,可采取缩短置管时间的措施.

  3. 腹腔镜下胃底折叠术(Nissen)对胃食管反流合并喉咽反流的影响%Influence of laparoscopic nissen fundoplication on the laryngopharyngeal reflux

    Institute of Scientific and Technical Information of China (English)

    张云峰; 李建业; 于磊; 柯冀


    Objective To preliminarily study the influence of laparoscopic NISSEN fundoplication(LNF) on the patients who have gastroesophageal reflux disease (GERD)associated with laryngopharyngeal reflux (LPR).Methods 36 patients in our department from 2006 to 2011 who have GERD associated with LPR and accepted NISSEN were reviewed and analyzed.To summarize the clinical symptoms,the operation means,the pH monitoring and stroboscopic laryngoscopy,then compared with 36 patients of the same period who only accepted antacids treatment.Results Compared with control group,the results showed LNF can improve the 24-hour postoperation oropharyngeal pH,Reflux Symptoms Index(RSI),Reflux Finding Score(RFS) and the Voice Hindrance Index(VHI)in different degrees (P < 0.05).Conclusion LNF can control the acid reflux of patients who have LPR effectively,improve the long-term chronic stimulation of the regional laryngopharyngeal,and inhibit the generating of the secondary affection at a certain degree.%目的 初步探讨腹腔镜下Nissen手术对于胃食管反流(GERD)合并喉咽反流(LPR)患者的影响情况.方法 回顾性分析2006年8月至2011年7月收治并接受腹腔镜下Nissen手术的36例胃食管反流合并LPR患者,对其临床症状、手术方式、24hpH监测、频闪喉镜等资料进行归纳,与同期36例仅接受制酸剂治疗的患者做比较.结果 与单纯服药组患者相比,进行腹腔镜下Nissen手术患者术后喉咽部pH值、反流症状指标(RSI)、反流后果计分(RFS)、嗓音障碍指标(VHI)均有不同程度的改善(P<0.05).结论 腹腔镜下Nissen手术可有效控制LPR患者酸反流,改善喉咽局部的长期慢性刺激,在一定程度上抑制继发病变的产生.

  4. Treatment of Functional Gastrointestinal Disorders in Children and Future Challenges

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    K Eftekhari


    Full Text Available Functional gastrointestinal disorders (FGIDs are a common problem in children. These disorders in children are classified into the following categories according to the ROME III classification: Functional Dyspepsia, Irritable bowel syndrome (IBS, Abdominal Migraines, Childhood Functional abdominal pain (FAP, Childhood functional abdominal pain syndrome and functional constipation. FGIDs are diagnosed based on history and normal physical examination provided that there is no evidence of underlying disease such as anatomical abnormalities, infectious, inflammatory and malignancies. This group of poorly defined diseases represent a huge treatment challenge to the specialist, because, until now there is no therapy that has been effective in improving the symptoms. FGIDs also cause deep family problems as the disease interrupts their routine and positive response to treatment is rarely seen. On the other hand there is no objective document of the disease neither endoscopic, radiologic nor pathologic. Therapeutic strategies of FGIDs are: education and parent's assurance, detection and modifying physical and psychological stress, dietary intervention, pharmacological treatment, psychotherapy and other complementary medical treatments. Some foods may trigger the illness such as coffee, fatty foods and spicy foods, therefore they should be avoided. Lactose-free diet cannot improve symptoms of FGIDs, except in children with lactose intolerance. The beneficial effect of fiber supplement in children with FGIDs remains unknown but it has been useful in adults with IBS. Probiotics have potential efficacy in treating IBS but the efficacy in children with FGIDs remains uncertain and needs to be further studied. In patients with severe symptoms, pharmacological agents can be effective. These drugs include Antacids, Prokinetics, Anticholinergic, Tricyclic antidepressants (TCAS and Serotonergic agents (Agonists and anti agonists. Psychotherapy in FAP and IBS is

  5. "Supergreen" Renewables: Integration of Mineral Weathering Into Renewable Energy Production for Air CO2 Removal and Storage as Ocean Alkalinity (United States)

    Rau, G. H.; Carroll, S.; Ren, Z. J.


    Excess planetary CO2 and accompanying ocean acidification are naturally mitigated on geologic time scales via mineral weathering. Here, CO2 acidifies the hydrosphere, which then slowly reacts with silicate and carbonate minerals to produce dissolved bicarbonates that are ultimately delivered to the ocean. This alkalinity not only provides long-term sequestration of the excess atmospheric carbon, but it also chemically counters the effects of ocean acidification by stabilizing or raising pH and carbonate saturation state, thus helping rebalance ocean chemistry and preserving marine ecosystems. Recent research has demonstrated ways of greatly accelerating this process by its integration into energy systems. Specifically, it has been shown (1) that some 80% of the CO2 in a waste gas stream can be spontaneously converted to stable, seawater mineral bicarbonate in the presence of a common carbonate mineral - limestone. This can allow removal of CO2 from biomass combustion and bio-energy production while generating beneficial ocean alkalinity, providing a potentially cheaper and more environmentally friendly negative-CO2-emissions alternative to BECCS. It has also been demonstrated that strong acids anodically produced in a standard saline water electrolysis cell in the formation of H2 can be reacted with carbonate or silicate minerals to generate strong base solutions. These solutions are highly absorptive of air CO2, converting it to mineral bicarbonate in solution. When such electrochemical cells are powered by non-fossil energy (e.g. electricity from wind, solar, tidal, biomass, geothermal, etc. energy sources), the system generates H2 that is strongly CO2-emissions-negative, while producing beneficial marine alkalinity (2-4). The preceding systems therefore point the way toward renewable energy production that, when tightly coupled to geochemical mitigation of CO2 and formation of natural ocean "antacids", forms a high capacity, negative-CO2-emissions, "supergreen

  6. Drogas antituberculose: interações medicamentosas, efeitos adversos e utilização em situações especiais - parte 1: fármacos de primeira linha Antituberculosis drugs: drug interactions, adverse effects, and use in special situations - part 1: first-line drugs

    Directory of Open Access Journals (Sweden)

    Marcos Abdo Arbex


    Full Text Available Os objetivos principais do tratamento da tuberculose são curar o paciente e minimizar a possibilidade de transmissão do bacilo para indivíduos saudáveis. Reações adversas ou interações das drogas antituberculose entre si e com outros fármacos podem causar modificação ou descontinuação da terapêutica. Revisamos sucintamente o novo tratamento farmacológico da tuberculose introduzido pelo Ministério da Saúde do Brasil em 2009 e mostramos os mecanismos gerais de ação, absorção, metabolização e excreção dos medicamentos utilizados no esquema básico. Descrevemos as reações adversas e as interações (com medicamentos, alimentos e antiácidos assim como a abordagem mais adequada para situações especiais, como gravidez, amamentação, insuficiência hepática e renal. Também descrevemos os mecanismos pelos quais as interações das drogas antituberculose do esquema básico podem causar hepatite medicamentosa e as possíveis alternativas nessa situação.The main objectives of tuberculosis therapy are to cure the patients and to minimize the possibility of transmission of the bacillus to healthy subjects. Adverse effects of antituberculosis drugs or drug interactions (among antituberculosis drugs or between antituberculosis drugs and other drugs can make it necessary to modify or discontinue treatment. We briefly review the new guidelines for the pharmacological treatment of tuberculosis, introduced by the Brazilian National Ministry of Health in 2009, and describe the general mechanism of action, absorption, metabolization, and excretion of the first-line drugs used in the basic regimen. We describe adverse drug reactions and interactions (with other drugs, food, and antacids, as well as the most appropriate approach to special situations, such as pregnancy, breastfeeding, liver failure, and kidney failure. We also describe the mechanisms by which the interactions among the antituberculosis drugs used in the basic regimen

  7. Systemic and local effects of long-term exposure to alkaline drinking water in rats. (United States)

    Merne, M E; Syrjänen, K J; Syrjänen, S M


    Alkaline conditions in the oral cavity may be caused by a variety of stimuli, including tobacco products, antacids, alkaline drinking water or bicarbonate toothpaste. The effects of alkaline pH on oral mucosa have not been systematically studied. To assess the systemic (organ) and local (oral mucosal) effects of alkalinity, drinking water supplemented with Ca(OH)2 or NaOH, with pH 11.2 or 12 was administered to rats (n = 36) for 52 weeks. Tissues were subjected to histopathological examination; oral mucosal biopsy samples were also subjected to immunohistochemical (IHC) analyses for pankeratin, CK19, CK5, CK4, PCNA, ICAM-1, CD44, CD68, S-100, HSP 60, HSP70, and HSP90. At completion of the study, animals in the study groups had lower body weights (up to 29% less) than controls despite equal food and water intake, suggesting a systemic response to the alkaline treatment. The lowest body weight was found in rats exposed to water with the highest pH value and starting the experiment when young (6 weeks). No histological changes attributable to alkaline exposure occurred in the oral mucosa or other tissues studied. Alkaline exposure did not affect cell proliferation in the oral epithelium, as shown by the equal expression of PCNA in groups. The up-regulation of HSP70 protein expression in the oral mucosa of rats exposed to alkaline water, especially Ca(OH)2 treated rats, may indicate a protective response. Intercellular adhesion molecule-1 (ICAM-1) positivity was lost in 6/12 rats treated with Ca(OH)2 with pH 11.2, and loss of CD44 expression was seen in 3/6 rats in both study groups exposed to alkaline water with pH 12. The results suggest that the oral mucosa in rats is resistant to the effects of highly alkaline drinking water. However, high alkalinity may have some unknown systemic effects leading to growth retardation, the cause of which remains to be determined.

  8. A robotic system for the educational chemistry laboratory: Integrating a SCARA light industrial robot with ordinary laboratory devices to perform chemical operations (United States)

    Johnson, Wes W.

    Laboratory robotics had its origins in devices constructed to perform specific and invariant mechanical operations in the chemical laboratory. Examples of this type of automation equipment include: automatic titrators, fraction collectors, and autoanalyzers. With the advancements in the electronics and computer industries, it has been possible to build more flexible automated devices, which we now call robots. Programmable robots can be taught to do a variety of routine procedures and are a valuable asset in the chemical laboratory. However, it is becoming increasingly difficult to be able to initially set up or modify an existing automation without the assistance of a vendor expert. Automation manufacturers often impose restrictions on how a device may be used and reconfiguration of the device by the user is usually too complex for the average technician. Also, it is not uncommon to find automated systems that only support the use of one manufacturer's balance, diluter, or other device. This approach simplifies the work needed in the development and manufacturing processes of the robotic system. But, by neglecting to design systems that can accept a wide range of third party equipment, the manufacturer restricts the user's ability to independently design unique applications. To address these issues, an example robotic system was constructed at the University of Cincinnati (UC). In this work, the feasibility of creating a simple and flexible automation using ordinary laboratory devices controlled via RS-232 was investigated. The system devised can control any device that is RS-232 compatible and can be reconfigured to accept new devices easily. The basis for this system is ASCII text definition files used by the control software. The software uses the configuration information, including ASCII command sets, to implement control of the RS-232 devices. A common pharmacuetical analysis (The Acid Neutralizing Capacity of OTC Antacids) was selected and implemented using

  9. The risks and benefits of an Rx-to-OTC switch. The case of over-the-counter H2-blockers. (United States)

    Oster, G; Huse, D M; Delea, T E; Colditz, G A; Richter, J M


    In recent years, many new over-the-counter (OTC) medications have resulted from the granting of OTC status by the U.S. Food and Drug Administration to drug entities that previously were available only by prescription (Rx). While the benefits to consumers of Rx-to-OTC switches may be substantial, they also involve some degree of risk, as usage typically expands and physician supervision diminishes. This study explores the potential utility of techniques of decision analysis in evaluating the balance of these benefits and risks. Histamine H2 receptor antagonists (H2-blockers), which are currently available only by prescription, are presented as a case study and were examined to determine how OTC availability of these agents would alter the patterns, effectiveness, and risks of self-treatment for acid-peptic disorders. Currently, about 5.7 million persons experience an episode of dyspepsia during any given quarter, of whom 3.5 million self-medicate with antacids. Study results indicate that OTC availability of H2-blockers would: 1) increase the proportion of persons with dyspepsia who self-medicate from 61.8% currently to 64.1%; 2) increase the proportion of persons who experience complete relief of their symptoms while self-medicating from 37.9% currently to 43.2%; 3) result in 14 additional cases of serious hematologic disorders and an additional 22,000 instances of minor side effects per quarter, but cause the overall rate of side effects among persons who self-medicate to decline; 4) cause an additional 300 persons per quarter with gastric cancer to self-medicate before seeking professional care, but cause no change in the median time between onset of symptoms and the decision to seek such care; and 5) decrease by 277,000 the number of persons per quarter who seek professional care for dyspepsia. On balance, results suggest that OTC H2-blockers may be a relatively safe and effective means of self-care for acid-peptic disorders, and may substantially reduce the

  10. Serotonin receptor 3A polymorphism c.-42C > T is associated with severe dyspepsia

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    Grobbee Diederick E


    Full Text Available Abstract Background The association between anxiety and depression related traits and dyspepsia may reflect a common genetic predisposition. Furthermore, genetic factors may contribute to the risk of having increased visceral sensitivity, which has been implicated in dyspeptic symptom generation. Serotonin (5-HT modulates visceral sensitivity by its action on 5-HT3 receptors. Interestingly, a functional polymorphism in HTR3A, encoding the 5-HT3 receptor A subunit, has been reported to be associated with depression and anxiety related traits. A functional polymorphism in the serotonin transporter (5-HTT, which terminates serotonergic signalling, was also found associated with these psychiatric comorbidities and increased visceral sensitivity in irritable bowel syndrome, which coexistence is associated with higher dyspeptic symptom severity. We investigated the association between these functional polymorphisms and dyspeptic symptom severity. Methods Data from 592 unrelated, Caucasian, primary care patients with dyspepsia participating in a randomised clinical trial comparing step-up and step-down antacid drug treatment (The DIAMOND trial were analysed. Patients were genotyped for HTR3A c.-42C > T SNP and the 44 bp insertion/deletion polymorphism in the 5-HTT promoter (5-HTTLPR. Intensity of 8 dyspeptic symptoms at baseline was assessed using a validated questionnaire (0 = none; 6 = very severe. Sum score ≥20 was defined severe dyspepsia. Results HTR3A c.-42T allele carriers were more prevalent in patients with severe dyspepsia (OR 1.50, 95% CI 1.06-2.20. This association appeared to be stronger in females (OR 2.05, 95% CI 1.25-3.39 and patients homozygous for the long (L variant of the 5-HTTLPR genotype (OR 2.00, 95% CI 1.01-3.94. Females with 5-HTTLPR LL genotype showed the strongest association (OR = 3.50, 95% CI = 1.37-8.90. Conclusions The HTR3A c.-42T allele is associated with severe dyspeptic symptoms. The stronger association among

  11. Interação fármaco-nutriente: uma revisão Drug-nutrient interaction: a review

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    Mirian Ribeiro Leite MOURA


    Full Text Available A dieta influencia todos os estágios do ciclo da vida, fornecendo nutrientes necessários ao sustento do corpo humano. Alterações de ordem funcional e/ou estrutural, provocadas por doenças e infecções agudas ou crônicas, levam à utilização de medicamentos, cujo objetivo é restaurar a saúde. A via preferencial escolhida para a sua administração é a oral, entre outras razões, por sua comodidade e segurança. O fenômeno de interação fármaco-nutriente pode surgir antes ou durante a absorção gastrintestinal, durante a distribuição e armazenamento nos tecidos, no processo de biotransformação ou mesmo durante a excreção. Assim, é de importância fundamental conhecer os fármacos cuja velocidade de absorção e/ou quantidade absorvida podem ser afetadas na presença de alimentos, bem como aqueles que não são afetados. Por outro lado, muitos deles, incluindo antibióticos, antiácidos e laxativos podem causar má absorção de nutrientes. Portanto, o objetivo do presente artigo é apresentar uma revisão dos diversos aspectos envolvidos na interação fármaco-nutriente.Diet influences the whole life cycle, supplying nutrients required to maintain the human body. Functional and/or structural alterations, caused by diseases and acute or chronic infections, lead to the use of drugs in order to restore the health. The oral route is preferred for drug administration, owing to safety and convenience, among other reasons. The drug-nutrient interaction phenomenon can occur before or during gastrointestinal absorption, during distribution and storage in the tissues, in the biotransformation process, or even during excretion. Thus, to know the drugs whose rate of absorption and/or absorbed amount can be affected in the presence of food, as well as those that are not affected, is of fundamental importance. On the other hand, a number of commonly used drugs, including antibiotics, antacids and laxatives, can cause malabsorption of

  12. Evaluation of geochemical characteristics and health effects of some geophagic clays southern Nigeria. (United States)

    Olatunji, A S; Olajide-Kayode, J O; Abimbola, A F


    , hypertension and cardiac failure with minor cases of respiratory tract infections. The high concentrations of the PHEs may be responsible for or contribute in part to the prevalence of hypertension, cardiac failures and gastrointestinal problems within the study areas. Though the kaolinite present in the geophagic clays makes them suitable for use as traditional antacids; however, the toxic trace element concentrations and significant quartz content will most likely mask the beneficial effects of such kaolinite.

  13. Adverse events of standardized regimens of corticosteroids for prophylaxis and treatment of nerve function impairment in leprosy: results from the 'TRIPOD' trials. (United States)

    Richardus, Jan H; Withington, Stephen G; Anderson, Alison M; Croft, Richard P; Nicholls, Peter G; Van Brakel, Wim H; Smith, W Cairns S


    Reactions in leprosy causing nerve function impairment (NFI) are increasingly treated with standardized regimens of corticosteroids, often under field conditions. Safety concerns led to an assessment of adverse events of corticosteroids, based on data of three trials studying prevention of NFI (the TRIPOD study). A multicentre, randomized, double-blind placebo-controlled trial was conducted in leprosy control programmes in Nepal and Bangladesh. Treatment was with prednisolone according to fixed schedules for 16 weeks, starting in one trial with 20 mg/day (prophylactic regimen: total dosage 1.96 g) and in the other two trials with 40 mg/day (therapeutic regimen: total dosage 2.52 g). Minor adverse events were defined as moon face, fungal infections, acne, and gastric pain requiring antacid. Major adverse events were defined as psychosis, peptic ulcer, glaucoma, cataract, diabetes and hypertension. Also, the occurrence of infected plantar, palmar, and corneal ulceration was monitored, together with occurrence of TB. Considering all three trials together, minor adverse events were observed in 130/815 patients (16%). Of these, 51/414 (12%) were in the placebo group and 79/401 (20%) in the prednisolone group. The relative risk for minor adverse events in the prednisolone group was 1.6 (P = 0.004). Adverse events with a significantly increased risk were acne, fungal infections and gastric pain. Major adverse events were observed in 15/815 patients (2%); 7/414 (2%) in the placebo group and 8/401 (2%) in the prednisolone group. No major adverse events had a significantly increased risk in the prednisolone arm of the trials. No cases of TB were observed in 300 patients who could be followed-up for 24 months. Standardized regimens of corticosteroids for both prophylaxis and treatment of reactions and NFI in leprosy under field conditions in developing countries are safe when a standard pre-treatment examination is performed, treatment for minor conditions can be carried out

  14. Does Helicobacter pylori eradication therapy for peptic ulcer prevent gastric cancer?

    Institute of Scientific and Technical Information of China (English)

    Katsuhiro Mabe; Mikako Takahashi; Haruhumi Oizumi; Hideaki Tsukuma; Akiko Shibata; Kazutoshi Fukase; Toru Matsuda; Hiroaki Takeda; Sumio Kawata


    AIM: To investigate the effects of Helicobacter pylori (H pylori ) eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS: A multicenter prospective cohort study was conducted between November 2000 and December 2007 in Yamagata Prefecture, Japan. The study included patients with H pylori -positive peptic ulcer who decided themselves whether to receive H pylori eradication (eradication group) or conventional antacid therapy (non-eradication group). Incidence of gastric cancer in the two groups was determined based on the results of annual endoscopy and questionnaire surveys, as well as Yamagata Prefectural Cancer Registry data, and was compared between the two groups and by results of H pylori therapy. RESULTS: A total of 4133 patients aged between 13 and 91 years (mean 52.9 years) were registered, and 56 cases of gastric cancer were identified over a mean follow-up of 5.6 years. The sex- and age-adjusted incidence ratio of gastric cancer in the eradication group, as compared with the non-eradication group, was 0.58 (95% CI: 0.28-1.19) and ratios by follow-up period (< 1 year, 1-3 years, > 3 years) were 1.16 (0.27-5.00), 0.50 (0.17-1.49), and 0.34 (0.09-1.28), respectively. Longer follow-up tended to be associated with better prevention of gastric cancer, although not to a significant extent. No significant difference in incidence of gastric cancer was observed between patients with successful eradication therapy (32/2451 patients, 1.31%) and those with treatment failure (11/639 patients, 1.72%). Among patients with duodenal ulcer, which is known to be more prevalent in younger individuals, the incidence of gastric cancer was significantly less in those with successful eradication therapy (2/845 patients, 0.24%) than in those with treatment failure (3/216 patients, 1.39%). CONCLUSION: H pylori eradication therapy for peptic ulcer patients with a mean age of 52.9 years at registration did not significantly decrease the

  15. Synthesis and characterization of metal (Core) - layered double hydroxide (Shell) nanostructures (United States)

    Noh, Woo C.

    Layered double hydroxides (LDH) which belong to a class of inorganic ceramic layered materials have been studied since the mid-19th century for a variety of applications including catalysis, anion exchange, adsorbents and antacid, but more recently as a potential drug and gene delivery platform. Drug delivery platforms based on nano-sized geometries are nanovectors which promise a revolutionary impact on the therapy and imaging of various types of cancers and diseases. To date, various polymeric platforms have been the focus of intense research, but the development of inorganic, bio-hybrid nanoparticles for therapeutics and molecular imaging are at a stage of infancy. The hybridization of LDH with bioactive agents or the fabrication of metal (Core)---LDH (Shell) nanostructures could have many beneficial effects including multimodality, active targetability, and efficacy. For example, Core---Shell nanostructures may be designed to have a high scattering optical cross-section for imaging, but may also be tailored to strongly absorb near infrared (NIR) light for hyperthermic ablation. The central theme of this thesis was to demonstrate proof-of-concept of spherical silver and gold metal (Core)---LDH (Shell) nanostructures that have uniform size distribution and are agglomeration free. The effects of processing parameters on the characteristics of LDH as well as LDH-coated spherical metal (Ag, Au) nanoparticles have been evaluated using X-ray Diffraction, Dynamic Light Scattering, Scanning Electron Microscopy, Transmission Electron Microscopy, Rutherford Backscattering Spectrometry, and Inductively Coupled Plasma Emission Spectrometry to arrive at appropriate process windows. The core---shell nanostructures were also characterized for their optical properties in the ultra---violet---visible region, and the data were compared with simulated data, computed by using a quasi static model from Mie scattering theory. Moreover, in order to achieve a strong plasmon resonance

  16. Historical impact to drive research in peptic ulcer disease. (United States)

    Banić, M; Malfertheiner, P; Babić, Z; Ostojić, R; Kujundzic, M; Fatović-Ferenčić, S; Plesko, S; Petričušić, L


    , Dragstedt, mid 20th century). Antacids, protective agents, anticholinergics, and later gastrin antagonists and prostaglandins were used for decades in the treatment of peptic ulcer, with differing effects. The advent of the concept of H(2)-receptor antagonists (Black, 1970s) and the discovery of acid (proton) pumps in parietal cells (Ganser, Forte and Sachs, late 1970s) paved the way for potent (H(2) antagonists) and profound acid inhibition (proton pump inhibitors) that revolutionized the treatment of acid-related disorders, including peptic ulcer disease. Worldwide, peptic ulcer and its complications remain the cause of significant morbidity, especially in older age groups, representing a major burden for ambulatory and hospital healthcare resources.

  17. Etiopathogenetic principles and peptic ulcer disease classification. (United States)

    Tytgat, G N J


    Ulceration corresponds to tissue loss, breaching the muscularis mucosae. When ulcers develop in the acid-peptic environment of the gastroduodenum, they are traditionally called peptic ulcer (PUD). Ulcers never develop spontaneously in a healthy gastroduodenal mucosa. Ulceration is the ultimate consequence of a disequilibrium between aggressive injurious factors and defensive mucosa-protective factors. The dominant aggressors are strong acid and high proteolytic (pepsin) activity in gastric secretions. The dominant defensors are the phospholipid surfactant layer, covering the mucus bicarbonate gel, the mucus bicarbonate layer covering the epithelium, the tight junctional structures between the epithelial cells, restricting proton permeability, and the epithelial trefoil peptides, contributing to healing after injury. Initially, acid-peptic aggression was considered the overwhelming cause of PUD, supported by the pioneering work of Schwartz, launching the dictum 'no acid, no ulcer'. This led to the universal therapy directed against intragastric acidity, also interfering with peptic activity when the pH was >4. The therapeutic sequence went from large doses of antacids to H(2)-receptor antagonists and finally to proton pump inhibitors (PPIs). The longer the intragastric pH was >3, the quicker ulcer healing was seen. Unfortunately, ulcers often recurred after stopping therapy, demanding maintenance therapy to keep the ulcers healed and to prevent the need for surgery (vagotomy, partial gastric resection). Later on, the emphasis gradually shifted to weakening/failing of the defensive factors, raising the vulnerability of the gastroduodenal mucosa to luminal secretions. Leading injurious mechanisms jeopardizing the mucosal integrity are numerous: infections, especially Helicobacter pylori, drug-induced injury, particularly acetylsalicylic acid (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs), physicochemical and caustic injury, vascular disorders, interfering

  18. 综合重症监护病房肠杆菌科细菌致血流感染发生的危险因素%Risk factors of bloodstream infections caused by enterobacteriaceae and related prognostic factors in general intensive care unit

    Institute of Scientific and Technical Information of China (English)

    孙伏喜; 冯旰珠; 高天明; 张扬; 赵水娣


    analysis. Results There were 35 cases BSI caused by enterobacteriaceae in all 96 patients with hospital-acquired bloodstream infections and the mortality was 42.9%(n=15). The relevant risk factors included acute pancreatitis, abdominal surgery and use of antacids(P<0.05 or 0.01) after a comparison of baseline conditions and clinical characteristics of patients between BSI caused by enterobacteriaceae and non-enterobacteriaceae. And the single factor and multi-factor Logistic regression analysis showed that their prognostic factors included patient age, acute physiology and chronic health evaluation(APACHE) Ⅱ score, tracheal intubation or incision and extended-spectrum beta-lactamase(ESBL) positive(P<0.05). Conclusion The patients admitted into general intensive care unit with acute pancreatitis, abdominal surgery and use of antacids are more likely to suffer from EBSI. And patient age, APACHE Ⅱ score, tracheal intubation or incision and ESBL are important prognostic factors.

  19. Clinical pharmacokinetics and pharmacodynamics of mycophenolate in patients with autoimmune disease. (United States)

    Abd Rahman, Azrin N; Tett, Susan E; Staatz, Christine E


    Mycophenolic acid (MPA), the active drug moiety of mycophenolate, is a potent immunosuppressant agent, which is increasingly being used in the treatment of patients with various autoimmune diseases. An understanding of the pharmacokinetics and pharmacodynamics of mycophenolate in this population should assist the clinician with rational dosage decisions. This review aims to provide an overview of the published literature on the clinical pharmacokinetics of mycophenolate in autoimmune disease and a briefer summary of current pharmacodynamic knowledge, and to identify areas of potential future research in this field. A literature search was conducted using PubMed and EMBASE databases as well as bibliographies of relevant articles and 'on-line early' pages of key journals. Twenty-six pharmacokinetic/pharmacodynamic studies of mycophenolate in people with autoimmune disease were identified and appraised. Twenty-two of these studies used non-compartmental analysis techniques and four used population modelling methods to estimate mycophenolate pharmacokinetic parameters. Seven studies linked mycophenolate exposure to treatment outcomes. Only four studies measured free (unbound) as well as total mycophenolate exposure and only two studies characterised MPA disposition following enteric-coated mycophenolate sodium (EC-MPS) administration. Across all studies MPA displayed erratic and complex pharmacokinetics with substantial between-subject variability. Based on total drug measurement, the dose-normalised MPA area under the plasma concentration-time curve (AUC) from 0 to 12 h post-dose (AUC12) varied at least five- to ten-fold between subjects. Typical values for apparent oral clearance (CL/F) of MPA during nonlinear mixed-effects modelling ranged from 8.3 to 25.3 L/h. Patient renal function, serum albumin levels, sex, ethnicity, food intake, concurrent administration of interacting drugs such as antacids, metal-containing medications and proton pump inhibitors and

  20. 晚期食道癌支架置入术并发症及其防治%Advanced Esophageal Cancer Prevention and Treatment of Complications of Stent Implantation

    Institute of Scientific and Technical Information of China (English)



    cases of moderate pain, after analgesic for the treatment of remission, 2 cases of hemoptysis symptoms, give aminomethylbenzoic acid intravenous drip, the symptoms in 1-2 days eased, 1 cases of reflux esophagitis, given antacid and gastrointestinal drugs in the treatment of symptoms disappear.Conclusion: after stenting in patients with oesophageal cancer prone to complications of a series of different degree, so medical personnel should be in the preoperative, intraoperative, postoperative strictly do prevention measures and relevant operation is the key to the prevention of complications.

  1. 早产儿支气管肺发育不良危险因素前瞻性队列研究%Prospective cohort study on risk factor for bronchopulmonary dysplasia in the premature infant

    Institute of Scientific and Technical Information of China (English)

    钟美珍; 白海涛; 刘登礼; 王礼周; 庄德义


    mortality of 15. 6% . ( 2 ) Multivariate Logistic regression analysis with backward ( Likehood ratio) method found that gestational age < 30 wk (OR = 3. 10), birth weight < 1500 g ( OR = 2. 29 ) , infectious pneumonia ( OR = 2. 74 ) , PDA ( OR = 2. 12) ,mechanical ventilation( OR =9. 57) , administration of H-2 antagonists or antacids ( OR = 1. 36) , administering advanced broad-spectrum antibiotics more than 4 weeks ( OR = 2. 59 ) were independent risk factors of BPD in premature infants. Conclusions The risk factors identified from this study aremultiple and may prove useful to target future clinical interventions to prevent BPD in premature infant.

  2. Risk factors for healthcare-associated infection in patients with cerebro-vascular diseases%脑血管病患者医院感染危险因素

    Institute of Scientific and Technical Information of China (English)

    夏应勇; 王立云; 赵玉美


    目的:了解神经内科脑血管病患者医院感染现状及相关危险因素。方法对2013年1—12月某院脑血管病患者医院感染情况和危险因素进行调查分析。结果3573例脑血管病患者,发生医院感染214例,感染率为5.99%;感染部位以呼吸道(54.67%)为主,其次为泌尿道(25.23%)。单因素分析结果显示,年龄、住院时间、意识障碍、患慢性阻塞性肺疾病(COPD)和糖尿病、侵入性操作、使用抑酸剂、预防性使用抗菌药物与发生医院感染均相关(P <0.05)。多因素 logistic 回归分析显示,意识障碍、高龄、侵入性操作、患 COPD 和糖尿病是脑血管病患者发生医院感染的独立危险因素(均 P <0.05)。结论神经内科患者医院感染发生率较高,引起医院感染危险因素较多,应针对以上因素进行合理干预,减少医院感染的发生。%Objective To understand the incidence and related risk factors of healthcare-associated infection(HAI)in neu-rological patients with cerebrovascular diseases.Methods The occurrence and risk factors of HAI in patients with cerebro-vascular diseases in a hospital between Jan and December 2013 were investigated and analyzed.Results Of 3 573 investiga-ted patients,214 had HAI,the incidence of HAI was 5.99%;the main infection site was respiratory tract (54.67%),fol-lowed by urinary tract (25.23%).Univariate analysis revealed that age,length of hospitalization,disturbance of conscious-ness,chronic obstructive pulmonary disease,diabetes mellitus,invasive procedures,application of antacids,and antimicro-bial prophylaxis were all related to the occurrence of HAI (P<0.05).Multivariate logistic regression analysis revealed that disturbance of consciousness,old age,invasive procedures,chronic obstructive pulmonary disease,and diabetes mellitus were independent risk factors for the occurrence of HAI (all P <0.05).Conclusion The incidence of HAI is

  3. Prevalência do uso de medicamentos na gravidez: uma abordagem farmacoepidemiológica Prevalence of drug use during pregnancy: a pharmacoepidemiological approach

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    Márcia Regina Campos Costa da Fonseca


    retrospective study on the pattern of drug use during pregnancy was conducted among 1,000 mothers who were interviewed using a structured questionnaire after delivery, while they were still in hospital. The following parameters were registered: sociodemographic characteristics, obstetric and contraceptive history, data on prenatal care and medications used during pregnancy. Statistical analysis was performed using ANOVA and chi-square test at p = 0.05. RESULTS: Among the interviewed patients, 94.6% had taken at least one medication during pregnancy, and 46.1% had used medication in the first trimester. Of 3,778 medications reported, 88.8% had been prescribed by a doctor. The median of medications taken was 3 (ranging from 0 to 18. The six most used classes of medications were: analgesics, spasmolytics, gynecological antiinfectious agents, antianemics, antacids and systemic antibiotics. The five most used medications were: butyl scopolamine, ferrous sulfate, dipirone, nistatin and multivitamin tablets. Only 27.7% of the patients had been alerted to the risk of taking medication during pregnancy. CONCLUSION: Knowing the profile of medications used during pregnancy may help devising programs to provide information to the patients and continuing education to health care professionals.


    Directory of Open Access Journals (Sweden)

    Ani Isnawati


    Full Text Available Background. Since 2004, Malaria Program in Indonesia has used Artemisinin Combination Therapy (ACT to replace the chloroquine resistance. The recommended ACT is Artesunate dan Amodiaquine (AAQ combination for uncomplicated falciparum malaria. To relieve side effects and clinical complaints of malaria , health workers usually gave  symptomatic and other drugs in addition to antimalarial drugs. Methods. The methodology implemented in this study was a cross-sectional study to evaluate symptomatic and other drugs given together with antimalarial (AAQ to uncomplicated malaria subjects (patients infected by falciparum, vivax and mixed (falciparum dan vivax plasmodium. Data were collected from case report form in 6 months (July to December 2010 from 8 (eight sentinels puskesmas (primary health centers in North Sulawesi, Central Sulawesi, West Kalimantan and East Kalimantan. Results. Total number of cases (89,4% were given symptomatic and other drugs in addition to antimalarial drugs. Symptomatic and other drugs that mostly given were antipyretic/analgesic (90.8% and vitamin-mineral (70%. There seemed to be over-use of vitamin-minerals since the indication to giving those medications were not quite clear. Antibiotics were mostly given to subjects with gastrointestinal complaints such as nausea, vomiting, and abdominal pain. The administration of antibiotic for non-bacterial infection were  irrational. Antihistamines were given to 94,3% subjects without cold and flu, and this cases also be defined as inappropriate use of medicine. In addition, antacids were also given to 12,5 %  subjects  without gastrointestinal complaints to anticipate side effects of antimalarial. AbstrakLatar belakang.Tahun 2004 Program Pemberantasan Malaria mulai menggunakan ACT menggantikan klorokuin yang telah resisten. ACT yang direkomendasikan adalah kombinasi Artesunat dan Amodiakuin (AAq, untuk malaria falsiparum tanpa komplikasi. Untuk mengatasi efek samping obat malaria

  5. When Coke Is Not Hydrating

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    Mohammed Bahaa Aldeen MD


    Full Text Available A 47-year-old African American man was admitted with 4 days of back pain, nausea and vomiting, and low urine output. There was no history of fever, dysuria, frequency, hesitancy, viral symptoms, trauma, rash, or constipation. Despite his past medical history of hypertension, diabetes mellitus, and hyperlipidemia he denied taking any medications for 18 months, including nonsteroidal anti-inflammatory drugs, acetaminophen, or antacids. He denied smoking and alcohol but admitted to cocaine use. No significant FH. Physical examination results were as follows: BP 235/125 mm Hg, heart rate 90 beats/min, temperature 98°F, O2 saturation normal; lungs and heart normal, abdomen soft but bilateral costovertebral angle tenderness. Neurological examination was normal. Laboratory tests yielded the following results: creatinine (Cr 10.5 mg/dL (1.2 mg/dL in 2010, blood urea nitrogen 63 mg/dL, glucose 151 mg/dL, Ca 9.4 mg/dL, PO4 6.1 mg/dL, Hgb 15 g/dL, white blood cells (WBC 9100, platelets 167 000, amylase/lipase normal, aspartate aminotransferase/alanine aminotransferase (AST/ALT normal, bilirubin 1.4 mg/dL, alkaline phosphatase 39 IU/L, creatine phosphokinase 127 µg/L. Hepatic panel, C- and P-ANCA (cytoplasmic– and perinuclear–antineutrophil cytoplasm antibodies, respectively, anti-GBM (anti–glomerular basement membrane, antimyeloperoxidase, antinuclear antibody, and Helicobacter pylori were all negative. C3, C4 normal, urinalysis: 2+ blood, no white blood cells or eosinophils, no casts, no albumin, negative for nitrate/leukocyte esterase and bacteria. Imaging: chest radiograph, abdominal radiograph, computed tomography of the abdomen, electrocardiography, and transthoracic echocardiography were all normal. Course. The patient’s urine output declined from 700 to 400 cm3/d and the on third day he required hemodialysis with Cr 14 mg/dL. Renal biopsy showed typical findings of interstitial nephritis. The patient was dialyzed for 10 days and responded

  6. Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

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    Chao-Chih Lai


    Full Text Available Background: The causative pathogen is rarely identified in the emergency department (ED, since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods: We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results: Viruses (41.3% were the leading cause of gastroenteritis, with noroviruses (32.2% being the most prevalent, followed by bacteria (26.8% and Giardia lamblia (12.4%. Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53, household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96, attending a banquet (aOR 2.29; 95% CI, 1.64–3.20, dining out (aOR 1.70; 95% CI, 1.13–2.54, and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94 were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05, those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62, or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62 or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77 were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41, abdominal pain (TR 1.20; 95% CI, 1.07–1.41, and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98 were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05, winter season (aOR 0.45; 95% CI, 0.28–0.74, frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83, and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23 were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63. Conclusions: Acute bacterial gastroenteritis was highly associated with

  7. 重症患者呼吸机相关性肺炎的危险因素及预防策略%Risk factors for ventilator-associated pneumonia in critically sick patients and prevention strategies

    Institute of Scientific and Technical Information of China (English)

    傅丽琴; 姚惠萍; 李茜


    目的 探讨重症患者呼吸机相关性肺炎(VAP)的发病危险因素和预防策略.方法 对医院2009年6月-2011年5月ICU收治的入科时无肺部感染且进行机械通气>48 h患者的临床资料进行回顾性调查分析.结果 183例患者发生VAP83例,发生率45.4%,所有VAP患者共检出病原菌165株,其中革兰阴性杆菌最常见,占69.70%,革兰阴性杆菌中以乙酸钙鲍氏复合不动杆菌最多,占39.39%;其他病原菌革兰阳性球菌占25.45%和真菌占4.85%;年龄≥60岁、机械通气时间≥5d、意识障碍、曾使用制酸剂、白蛋白<30 g和侵入性操作为VAP发生的危险因素.结论 重症患者VAP的发生与上述危险因素有关,应采取严密监控、规范洗手、加强保护性护理、严格呼吸道管理、改进营养支持方法等针对性的非药物干预措施,以减少VAP的发生.%OBJECTIVE To investigate the risk factors for ventilator-associated pneumonia (VAP) in critically sick patients and explore the prevention strategies. METHODS The clinical data of the patients with mechanical ventilation for more than 48 hours who enrolled in ICU without pneumonia from Jun 2009 to May 2011 were retrospectively analyzed. RESULTS Of 183 patients investigated, VAP occurred in 83 patients with the incidence of 45. 4% , and totally 165 strains of pathogens were isolated from all the VAP patients, including gram-negative bacilli (69. 70%), and among the gram-negative bacilli, Acinetobacter calcoacetius-baumannii were most common, accounting for (39. 39%); gram-positive cocci accounted for 25. 45% and fungi accounted for 4. 85%; more than 60 years of age, mechanical ventilation more than 5days, disturbance of consciousness,use of antacids, albumen less than 30g and invasive operation were the risk factors for VAP. CONCLUSION The VAP in critically sick patients is related to the risk factors discussed above; close attention should be paid to the monitoring and the standardized hand

  8. 影响脓毒症病人肠内营养耐受性因素的分析%An analysis of enteral nutrition-related tolerance influencing factors in septic patients

    Institute of Scientific and Technical Information of China (English)

    刘晓蓉; 王凯; 王一曼; 徐杰; 任新生


    目的:通过对脓毒症病人肠内营养(EN)耐受性影响因素的分析,探讨影响EN吸收的相关因素.方法:选取脓毒症病人85例,所选择的病人均符合脓毒症诊断标准,存在感染或高度怀疑存在感染同时,符合全身性炎症反应综合征(SIRS) ≥2项标准者,通过可能影响脓毒症病人EN耐受的因素分析,观察不同影响因素对脓毒症EN病人24至72 h内胃肠道的反应,探讨影响脓毒症病人EN耐受性的因素. 结果:当病人使用镇静药和抑酸药、机械通气、低蛋白血症(血清清蛋白<35 g/L)、粪肠球/杆菌比例≥2:8、APARCHⅡ评分≥15分和营养液渗透浓度≥330 mmol/L时,胃肠道各种不良反应的发生率明显增高,置入空肠营养管后不良反应的发生率明显减少. 结论:镇静药、抑酸药、机械通气、血清清蛋白水平、粪肠球/杆菌比例、EN途径、APARCHⅡ评分、营养液渗透浓度等对脓毒症病人EN的耐受性有不同程度影响.%Objective: It is the purpose of this article to investigate the related factors to intestinal absorption of nutrients of eternal nutrition by analyzing enteral nutrition-relaled tolerance influencing factors in septic patients. Methods : 85 patients diagnosed as sepsis in Intensive Care Unit (ICU) from 1st December,2006 to October 30th,2010 were enrolled by diagnostic standard of sepsis, observing gas trointestinal reaclions treated by nasal feeding within 24-72 hours in different groups of eternal nutrition, in order to explore different influencing factors related tolerance of enteral nutrition in septic patients. Results-, When the sedatives and antacids were given, vomiting, diarrhea, aspiration, gastric retention and abdominal distension were significantly increased. The same situation also happened easily in certain patients with hypoproteinemia serum albumin level (less than 35 g/L) , stool coccobacteria and bacilus ratio ≥ 2:8, APARCH II≥ 15, diarrhea or nutrient solution

  9. Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. (United States)

    Tablan, Ofelia C; Anderson, Larry J; Besser, Richard; Bridges, Carolyn; Hajjeh, Rana


    This report updates, expands, and replaces the previously published CDC "Guideline for Prevention of Nosocomial Pneumonia". The new guidelines are designed to reduce the incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings (e.g., ambulatory and long-term care institutions) and other facilities where health care is provided. Among the changes in the recommendations to prevent bacterial pneumonia, especially ventilator-associated pneumonia, are the preferential use of oro-tracheal rather than naso-tracheal tubes in patients who receive mechanically assisted ventilation, the use of noninvasive ventilation to reduce the need for and duration of endotracheal intubation, changing the breathing circuits of ventilators when they malfunction or are visibly contaminated, and (when feasible) the use of an endotracheal tube with a dorsal lumen to allow drainage of respiratory secretions; no recommendations were made about the use of sucralfate, histamine-2 receptor antagonists, or antacids for stress-bleeding prophylaxis. For prevention of health-care--associated Legionnaires disease, the changes include maintaining potable hot water at temperatures not suitable for amplification of Legionella spp., considering routine culturing of water samples from the potable water system of a facility's organ-transplant unit when it is done as part of the facility's comprehensive program to prevent and control health-care--associated Legionnaires disease, and initiating an investigation for the source of Legionella spp. when one definite or one possible case of laboratory-confirmed health-care--associated Legionnaires disease is identified in an inpatient hemopoietic stem-cell transplant (HSCT) recipient or in two or more HSCT recipients who had visited an outpatient HSCT unit during all or part of the 2-10 day period before illness onset. In the section on aspergillosis, the revised recommendations

  10. Analysis of drug use for treating peptic ulcer in our hospital during 2008-2010%2008-2010年我院抗消化性溃疡用药分析

    Institute of Scientific and Technical Information of China (English)

    雒晓科; 脱鸣富; 王奕玲


    目的:调查分析我院2008-2010年抗消化性溃疡药使用情况,为临床合理用药、药品采购提供参考.方法:收集2008-2010年我院药品出库数据,采用Microsoft Excel 2000统计分析方法.按抗消化性溃疡的药物类别、品种、剂型、国产或进口、使用进口药的医生职称来统计药物销售金额,DDDs及用药频度.结果:我院抗消化性溃疡药以质子泵抑制剂(PPI)为主,片剂和注射剂是常用给药形式,国产药占主导地位,初级职称医生使用进口药品较多.在常用药中,PPI类的兰索拉唑片、注射用泮托拉唑钠和注射用奥美拉唑;H2受体拮抗剂类的复方盐酸雷尼替丁胶囊;抗酸药类的铝碳酸镁咀嚼片;胃黏膜保护剂类的胶体果胶铋胶囊和复方谷酰胺颗粒的DDDs和销售金额较高.结论:PPI及国产药是我院抗消化性溃疡用药的主体.但是日用费用相对较高,存在一定大处方现象.%Objective: To investigate and analyze the use of peptic ulcer medicines in our hospital during 2008 -2010, providing reference for the clinically rational use of drugs and drug procurement. Methods: The drug outbound data in our hospital during 2008 -2010 were collected, and the Microsoft excel was used for statistical a-nalysis. The drug classes, drug varieties, dose forms, domestic and imported, use of imported drugs by different title doctors, statistics of the drug sales amount, DDDs and drug use frequency were analyzed. Results: H+ pump inhibitors was the priority of peptic ulcer medicines in our hospital, tablet and injection were the commonly used dose forms, domestic medicines were dominant, and primary title doctors used more imported drugs. The frequently used drugs included the H + pump inhibitors (lansoprazole tablets, and pantoprazole and omeprazole injections) , the H2 receptor antagonists ( compound ranitidine hydrochloride capsules) , the antacids like aluminum magnesium carbonate chewable tablets, and the

  11. Effect of antidepressant treatment on water load test and cortisol changes in patients with functional dyspepsia

    Institute of Scientific and Technical Information of China (English)


    BACKGROUND: It has been demonstrated that patients with functional dyspepsia have experiences social life stress events, and accompanied by psychological disorders, mainly manifested as depression and anxiety.Mental factors can lead to excessive gastrointestinal consensual reaction, and result in different brain-gut axis disturbance, and then cause the gastrointestinal sensorimotor abnormality and endocrine changes.OBJECTIVE: To observe the effect of antidepressant treatment on the changes of water load and serum cortisol in patients with functional dyspepsia, and analyze the therapeutic mechanism.DESIGN: A comparative observation.SETTING: The First Affiliated Hospital o Zhengzhou University.PARTICIPANTS: Forty-five patients with functional dyspepsia accompanied by depression were selected from the Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University from July 2004 to July 2006, and they were 25 - 65 years of age, and their disease courses ranged 1 - 10 years. They were all accorded with the diagnostic standards for Rome Ⅱ functional dyspepsia functional dyspepsia. As the patients' will, they were divided into treatment group (n =30, 12 males and 18 females) and control group (n =15, 6 males and 9 females), and there were no significant differences in the data between the two groups (P > 0.05). The programs were discussed and agreed by the committee of medical ethics of the First Affiliated Hospital of Zhengzhou University. Informed contents were obtained from all the patients.METHODS: In the treatment group, the patients were treated with venlafaxine sustained release capsule (75 mg per day), and those with sleep disorder were added by benzodiazepines (alprazolam). In the control group, the patients were given routine treatments of antacid, prokinetics, etc. Before and after 8-week treatment, the following examinations were performed: ① The gastrointestinal symptoms were assessed according to the symptoms; ② The severity of

  12. The clinical analysis of esophageal hiatal hernia misdiagnosed as coronary heart disease in 32 cases%食管裂孔疝误诊为冠心病32例

    Institute of Scientific and Technical Information of China (English)

    翟英慧; 郝咏刚; 李海涛; 安萍; 邹文; 尹伟


    Objective To explore the clinical characteristics of esophageal hiatal hernia similar to coronary heart disease,in order to reduce the misdiagnosis or missed diagnosis of hiatal hernia.Methods From January 2000 to December 201 3,32 cases of who presented a chest pain were diagnosed as hiatal hernia in our hospital.The clinical manifestations,causes and mitigation methods,ECG,and etc.were analyzed. Hiatal hernia was diagnosed by two methods:electronic gastroscopy and X-ray upper gastrointestinal contrast. Results The patients initially received drug treatment,such as antacids and drugs for promoting esophageal, gastric emptying.24 patients were improved and then discharged from hospital.While,8 conversions to surgical treatment were necessary due to failure of drug treatment.Conclusions Esophageal hiatus hernia may have similar symptoms with coronary heart disease.For aged patients with chest pain,in addition to the consideration of coronary heart disease,we should give X ray or gastroscopy examination in time,to improve the detection rate and to reduce the misdiagnosis and missed diagnosis of hiatal hernia.%目的:探讨症状酷似冠心病的食管裂孔疝的临床特点,以减少该病误诊或漏诊的发生。方法对2000年1月至2013年12月,北京市普仁医院诊断的伴有胸痛的食管裂孔疝32例患者的临床表现、诱因与缓解方法、心电图表现等方面进行分析,食管裂孔疝的诊断采用电子胃镜检查及X线上消化道造影二种方法。结果32例患者的首先给予药物治疗以抑酸剂促进食管、胃排空药物等。24例患者症状明显缓解,好转出院。8例患者上述药物治疗效果失败转外科手术治疗。结论食管裂孔疝的症状与冠心病相似,对于中老年胸痛患者,除了考虑冠心病以外,应及时行X线检查或胃镜检查,可提高食管裂孔疝的检出率,以减少误诊和漏诊的发生。

  13. 腹腔镜食管裂孔疝修补术143例临床分析%Laparoscopic hiatal hernia repair: a clinical analysis of 143 cases

    Institute of Scientific and Technical Information of China (English)

    赵宏志; 秦鸣放; 王庆; 勾承月; 李宁


    Objective To explore the feasibility and clinical value of laparoscopic surgery in treating patients with hiatal hernia. Methods From June 2001 to February 2010, 143 cases of hiatal hernia were enrolled to undertake laparoscopic hiatal hernia repair at Nankai Hospital of Tianjin City. Laparoscopic fundoplication was performed concomitantly in some cases if appropriate. Paraoperative clinical parameters were recorded and analyzed. All cases were followed up routinely. Clinical outcomes were collected and analyzed. Results All 143 cases of laparoscopic operations were accomplished successfully. No conversions were needed. Mean operation time was 86 minutes (range: 55-210 minutes). Mean intraoperative blood lose was 76 mL (range: 40-150 mL). Mean postoperative hospital stay was 4.6 days (range: 3-21 days). Clinical symptoms were relieved in all cases. No mortality and severe complications were noted.Mean follow up period was 3.8 years (range: 3 months to 9 years). Rate of satisfaction for operation was 91.67%. Mild dysphagia occurred in 8 cases. Reflux recurrence occurred in 5 cases, in whom 4 cases were controlled by antacid medicine and 1 case need open surgical revision. Conclusion Laparoscopic hiatal hernia repair has the advantages of minimal trauma, fast recovery, safe and high reliability.%目的 探讨腹腔镜手术治疗食管裂孔疝的可行性和临床应用价值.方法 对2001年6月至2010年2月天津市南开医院143例食管裂孔疝行腹腔镜食管裂孔疝修补术的资料进行分析.结果 143例均完成腹腔镜手术,无中转开腹病例,手术时间55~210min,平均86min;术中出血量40~150mL,平均76mL;术后住院时间3~21d.平均4.6d.术后临床症状均得到缓解,无严重并发症及死亡病例.134例得到随访,随访时间3个月至9年,平均3.8年,手术结果满意率91.67%.8例进固体食物时有轻度哽噎感,5例反酸症状复发,其中4例应用抑酸药物后可控制,1例行开腹手术治疗.结论


    Directory of Open Access Journals (Sweden)

    Yeganathan Rajappan


    Full Text Available BACKGROUND Perforation peritonitis is one of the commonest surgical emergency encountered by surgeons. The aim of the study is to provide an overview of aetiological factors causing peptic ulcer perforation and the factors affecting the outcome of management. MATERIALS AND METHODS This study was conducted at Mahathma Gandhi Memorial Hospital, Trichirapalli, between December 2014 and August 2015. This study included 81 cases of Peptic ulcer perforation who are managed with laparotomy or peritoneal drainage, were studied retrospectively for the factors causing peptic ulcer perforation, site of perforation, surgical management, complications and outcome and factors influencing outcome of management. Data analysed done by using SPSS 17 software with appropriate statistical test. RESULTS The incidence of Peptic ulcer perforation at MGM Hospital has been worked out to be <1% (0.74%. Peptic ulcer perforation is commonly seen in 5th decade of life; 65% of the cases in the age group of 25 to 55 years. The youngest patient was 15 years old and the oldest 70 years old. Male:Female ratio is 9:1. More commonly seen in people who are having blood group “O” constituting 49% of the total. Past history of peptic ulcer was present in 73% of cases of perforation; 65.4% of the cases are addicted to chronic smoking and 66.7% of the cases are addicted to alcohol; 94% were taking mixed diet. Family history of peptic ulcer was present in 32% of the cases of duodenal ulcer perforation; 94% patients consume diet with plenty of chillies and spices. Out of 73% of cases with past history of duodenal ulcer, 80-85% of patients had taken medical treatment with antacids and H2 receptor blockers, proton pump inhibitors drugs irregularly. Diagnosis was made on clinical history and physical examination of abdomen and aided by plain X-ray abdomen in erect posture, which showed pneumo-peritoneum in 96.3% of cases of duodenal ulcer perforations. Obliteration of liver dullness was

  15. Úlcera gastroduodenal em potros Gastroduodenal ulcer in foals

    Directory of Open Access Journals (Sweden)

    Antonio Cezar de Oliveira Dearo


    balance between protective and aggressive factors is suggested and once the last is predominant the ulcer would be established. According to the kind, presence or absence of clinical signs, the locadon of lesions on gastric mucosa and its complications, four clinical syndromes are described in foals: 1 silent ulcers, 2 active ulcers, 3 perforated ulcers and 4 gastric or duodenal obstruction. Diagnosis should be based on history, clinical signs, response to treatment and mainly on endoscopic findings. Gastric ulcers can be treated with drugs such as acid secretions inhibitors, local antacids, mucosal protectants, prostaglandin analogs and motility stimulants. If necessary, the surgical treatment can be used.

  16. Estoque domiciliar de medicamentos na comunidade ibiaense acompanhada pelo Programa Saúde da Família, em Ibiá-MG, Brasil Drug storage at home in the community assisted by the Family Health Programme in Ibiá, MG, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Ângela Ribeiro


    á, state of Minas Gerais. The purpose was to describe users' characteristics, storage conditions, therapeutic classes and pharmaceutical forms, the origin of the drugs, as well as the cost of the drugs provided by the Public Health System. A total number of 285 households were visited from July to September 2004. It was verified that the average number of drugs per household was 8.4 and that 93.5% of the surveyed families had at least one sort of drug in stock. The most stored drugs were: analgesics (11.15%, diuretics (6.42%, antibacterials for systemic use (5.82%, anti-inflamatory drugs (5.08% and antacids (4.10%. Although there is a considerable number of drugs stored in the households, the number of drugs without prescription coming from the Public Health System was small. This is a good consequence of the Pharmaceutical Assistance services in the municipality. On the other hand, it was prescription (self-medication. In addition, 18.5% of the drugs were no longer valid for use. Part of the drug storage at home results from prescriptions in amounts that are higher than what is necessary for treatment (20.0%, from non-completion of the prescribed treatment (17.0% and from acquisition of drugs for self-medication (9.0%.The study suggests the need to educate users in relation to drugs utilization and storage, and the need to systematize data records in order to manage the resources more efficiently, which will lead to adequate decisions related to the Pharmaceutical Assistance policy.

  17. Vitamin C improves the apparent absorption of levothyroxine in a subset of patients receiving this hormone for primary hypothyroidism La vitamina C mejora la absorción aparente de levotiroxina en ciertos pacientes que reciben esta hormona por hipotiroidismo primario

    Directory of Open Access Journals (Sweden)

    PB Antúnez


    Full Text Available As in some patients with hypothyroidism, because of unknown reasons, large doses of levothyroxine are required to achieve a therapeutic endpoint, and preliminary observations have indicated that an hypoacidic gastric environment is associated with a reduction in levothyroxine bioavailability, and that co-administration of vitamin C might enhance absorption of certain drugs, we assessed whether this effect would be obtained taking levothyroxine with vitamin C. Design: We studied 28 patients (24 women and 4 men, age range 26-76 years; mean 48.0 ±17.75 treated with levothyroxine at doses of >1.70 µg/kg but failing to achieve their target TSH level. During the control period, each patient had at least two determinations of TSH indicating inadequate dosage. Interfering factors that could alter levothyroxine absorption such as celiac disease, calcium, iron, or antacid use, among others, and non-compliance were excluded. During the study period, the patients continued on the same dose of levothyroxine but took the tablet with 1 g of vitamin C in 200 cc of tap water, instead of the same volume of water alone. Serum TSH levels were prospectively measured 6-8 weeks after starting co-administration with vitamin C, and two months later. Main outcome: After six-eight weeks of taking levothyroxine with vitamin C, serum TSH decreased in all 28 patients (average reduction 69.79 ±22.19 %, and the target or desired level of TSH was achieved in 19/28 patients. The difference between TSH levels before and after treatment with vitamin C was significant: Basal TSH (IFMA was 9.01 ±5.51 mIU/L vs. a mean TSH on vitamin C treatment of 2.27 ±1.61mIU/L (pComo algunos pacientes con hipotiroidismo requieren altas dosis de levotiroxina para lograr el objetivo terapéutico, y existen observaciones de que el medio gástrico hipoacídico se asocia a reducción en la biodisponibilidad de la levotiroxina, y que la coadministración de vitamina C puede mejorar la absorción de

  18. 老年人医院内获得性肺炎的危险因素分析%A multicenter prospective cohort study on risk factors for hospital-acquired pneumonia in the elderly

    Institute of Scientific and Technical Information of China (English)

    邓至; 胡必杰; 何礼贤; 高晓东; 李华茵; 陈雪华; 王文娟; 任金兰; 韩红妹


    incidence of HAP was higher in ICU(21.43%),hematology(12.17%),chest surgery(11.41%),and respiratory medicine(7.92%)departments.The mean of acute physiology and chronic health evaluation (APACHE Ⅱ)score was 8.3±3.4(5-31).Multivariable logistic regression analysis with backward (Wald)method found that admission into secondary hospitals.admission into ICU,history of chronic obstructive pulmonary disease≥10 years,immunosuppression,administration of antibiotics,insertion of nasogastric tube,mechanical ventilation,administration of H-2 antagonists or antacid and≤7 d,central nervous system diseases,depressed level of consciousness,supine position,albumin<35g/L were independent risk factors of HAP in the elderly.Conclusion Hospital-acquired pneumonia in the elderly was the usual type of nosocomial infections.The risk factors identified from this study may prove useful to target future clinical interventions to prevent HAP in the elderly.

  19. Perioperative management of endoscopic retrograde cholangiopancreatography in the treatment of biliary complications following liver transplantation%内镜下逆行性胰胆管造影术治疗肝移植术后胆道并发症的围手术期管理

    Institute of Scientific and Technical Information of China (English)

    巫织娥; 林颖; 陶金; 梁艳娉; 郑丰平


    disinfection of surgical instruments, application of preoperative drugs, et al. The operators and nursing staff cooperated closely during the operation. Symptomatic treatments such as fasting, transfusion, anti-infection, antacids, somatostatin were given to the patients after operation. The nasobiliary ducts were properly ifxed and the conditions were closely observed. Health guidance was given to the patients after hospital discharge. Results In 102 patients, 94 patients were treated by ERCP successfully with the success rate of 92.2% (94/102). The curative rate was 77%(72/94), the improvement rate was 20%(19/94) and the total effective rate was 97%(91/94). Postoperative complications were observed in 15 cases including hyperamylasemia (n=8), mild pancreatitis (n=4), bleeding of the papillary muscles incision (n=3), and all were cured by conservative treatments. Conclusions Positive preoperative psychological counseling, close collaboration of medical staff during the operation, close observation on the postoperative complications and health guidance after hospital discharge are important factors for the success of ERCP in treating biliary complications following LT.

  20. Varnish XT和ICON渗透树脂对釉质龋白斑微硬度的影响%Effect of Varnish XT and ICON resin infiltration treatment on the microhardness of white spot lesions

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    郭静; 赵晓一; 吴佩玲


    to fil the region of enamel demineralization and prevent further development of lesions. OBJECTIVE:To study the effects of two minimaly invasive surgical treatment materials, Varnish XT and ICON penetrating resin, on the microhardness of enamel caries white spot. METHODS:Totaly 100 incisors of cows were selected, embedded with ethoxyline resin and polished. The lip side facing down served as the observation side. An area of at least 6 mm×10 mm on the enamel face was exposed, and there were five regions from incisal to dental cervix, A, B, C, D, E. After demineralization liquid for artificial caries, no treatment was adopted in region A, treatment with Varnish XT was for region B, treatment with ICON penetrating resin for region C, treatment with fluoride for region D, and region E was sealed with antacid nail. Surface micro-hardness was detected. RESULTS AND CONCLUSION: After demineralization, surface micro-hardness of regions A, B, C, D decreases remarkably as compared with region E (P B and D for surface micro-hardness with statistical significance (P 0.05). ICON resin infiltration, Varnish XT and fluoride have obvious improvement effects on surface micro-hardness, and ICON resin infiltration is superior to Varnish XT and fluoride.

  1. Analysis on correlation between combined medication and diarrhea in patients with long-term enteral nutrition%长期肠内营养治疗患者合并用药与腹泻的相关性分析

    Institute of Scientific and Technical Information of China (English)

    龙晓静; 刘菁; 曾英; 江涛; 张露艺; 陈冬梅


    Objective To study the relationship between combined medication and diarrhea occurrence in the patients with enteral nutrition. Methods Totally 263 inpatients with enteral nutrition support in our hospital from October 2014 to October 2015 were selected by adopting the retrospective case analysis. The use situation of enteral nutrition preparations and combined medication were recorded. The patients were divided into the diarrhea group(116 cases) and control group(147 cases) according to whether diarrhea occurring. The enteral nutrition preparations kinds and combined medication in the two groups were analyzed. Results The use rates of the gastric motor drugs ,potassium preparations and antacid agents in the diarrhea group were 50.9%, 40.5%and 70.7%respectively,which were respectively higher than 32.0%,19.7%and 24.5%in the control group,the differences had statistical significance(P<0.01). The use rates of glutamine,probiotic preparations and dietary fiber in the diarrhea group were 27.6%,35.3%and 28.4%respectively,which were respectively lower than 43.5%,69.4%and 40.8%in the control group,the dif-ferences had statistical significance(P<0.05 or 0.01). The simultaneous use of 2 drugs or more in the diarrhea group accounted for 72.4%(84/116),which was higher than 54.4%(80/147) in the control group,the difference was statistically significant(P<0.05). Conclusion The combined medication is a influencing factor in enteral nutrition related diarrhea. Conducting the enteral nutri-tion should optimize the prescription,and using the preparations easier to cause diarrhea should be reduced to minimal level or avoided as much as possible.%目的:分析肠内营养治疗患者合并用药与腹泻发生的关系。方法采用回顾性病例分析方法,选择广西中医药大学第一附属医院2014年10月至2015年10月行肠内营养支持治疗的住院患者263例,记录肠内营养制剂及合并用药的使用情况。按是否发生腹

  2. Efficacy of Jianpi Hewei therapy on gastrointestinal dysfunction in critical patients and blood lactic acid level%健脾和胃法对危重症患者胃肠功能障碍的防治作用及对血乳酸水平的影响

    Institute of Scientific and Technical Information of China (English)

    陈华琼; 郭应军; 侯杰; 刘八一; 王国军; 李平; 陈侯君


    Objective:The therapeutic effect of spleen and Stomach decoction ongastrointestinal dysfunction in critically ill patients and the influence on blood lactic acid level. Methods: ①The choice of 120 critically ill patients in Septamber 2007 to July 2014 ICU treated patients in Zhongshan Hospital of Traditional Chinese Medicine, has no gastrointestinal dysfunction were divided into negative group and positive group, and then were randomly divided into the treatment group and the control group, 30 cases in each group. ②The treatment group was given with spleen and stomach soup treatment. Drugs: Astragalus 15g, Atractylodes 10g, Poria cocos 15g, White Peony root 15 g, Angelica10g, Salvia15g, Rhubarb(later) 10g, Costas 10g, Chicken’s gizzard skin 10g, Radish seed10g, Malt 15g, Sage 10g, Coptis chinensis 5g, Wu Cornus officinalis 5g, Licorice 5g. The Chinese medicine provided by the Institute of medicine room:2 agent/d, water simmer in water 2, each agent take juice 170mL, 2 clothes or nasal feeding, 5d for a course of treatment, lack of 5d roll out ICU or automatic discharge,death, to roll out before or automaticdischarge, death before collecting the observation index. ③Control group:the use of antacids and gastrointestinal mucosal protective agent for prevention and treatment of gastric mucosa injury. Note that the changes of intestinal microflora, the application of microbial preparation to maintain normal intestinal flora proportion,imbalance of intestinal flora can be treated with oral vancomycin. From the beginning of patients in the ICU, to the patient’s condition improves ICU roll out, death or automatic discharge for the end of treatment, early nasogastric feeding plain water or enteral nutrition (to). ④The changes of serum lactic acid in patients before and afterimprovement, observation and treatment of gastrointestinal function. ⑤Mean standard deviation with the measurement data ( x ± s ) said that the test using group;measurement data with the

  3. Total allowable concentrations of monomeric inorganic aluminum and hydrated aluminum silicates in drinking water. (United States)

    Willhite, Calvin C; Ball, Gwendolyn L; McLellan, Clifton J


    Maximum contaminant levels are used to control potential health hazards posed by chemicals in drinking water, but no primary national or international limits for aluminum (Al) have been adopted. Given the differences in toxicological profiles, the present evaluation derives total allowable concentrations for certain water-soluble inorganic Al compounds (including chloride, hydroxide, oxide, phosphate and sulfate) and for the hydrated Al silicates (including attapulgite, bentonite/montmorillonite, illite, kaolinite) in drinking water. The chemistry, toxicology and clinical experience with Al materials are extensive and depend upon the particular physical and chemical form. In general, the water solubility of the monomeric Al materials depends on pH and their water solubility and gastrointestinal bioavailability are much greater than that of the hydrated Al silicates. Other than Al-containing antacids and buffered aspirin, food is the primary source of Al exposure for most healthy people. Systemic uptake of Al after ingestion of the monomeric salts is somewhat greater from drinking water (0.28%) than from food (0.1%). Once absorbed, Al accumulates in bone, brain, liver and kidney, with bone as the major site for Al deposition in humans. Oral Al hydroxide is used routinely to bind phosphate salts in the gut to control hyperphosphatemia in people with compromised renal function. Signs of chronic Al toxicity in the musculoskeletal system include a vitamin D-resistant osteomalacia (deranged membranous bone formation characterized by accumulation of the osteoid matrix and reduced mineralization, reduced numbers of osteoblasts and osteoclasts, decreased lamellar and osteoid bands with elevated Al concentrations) presenting as bone pain and proximal myopathy. Aluminum-induced bone disease can progress to stress fractures of the ribs, femur, vertebrae, humerus and metatarsals. Serum Al ≥100 µg/L has a 75-88% positive predictive value for Al bone disease. Chronic Al

  4. Value of nasojejunal nutrition in the treatment of children with acute pancreatitis%鼻空肠营养治疗在儿童急性胰腺炎中的应用价值

    Institute of Scientific and Technical Information of China (English)

    马鸣; 陈洁; 李甫棒; 楼金玕; 彭克荣; 赵泓; 陈飞波


    Objective To evaluate the feasibility and effectiveness of placement of nasojejunal feeding tube and nasojejunal nutrition feeding in children with acute pancreatitis.Method Twenty-two patients (of whom 13 had severe acute pancreatitis and 9 acute mild pancreatitis) who needed nutritional intervention were selected.They were from Department of Gastroenterology and Surgery during the years 2009-2012,and they were at high nutritional risk after STONGkid nutrition risk screening.The average age of them was 5-15 years (9.1 years ± 2.8 years).Assisted by endoscopy,the nasojejunal feeding tube was placed in 22 of 24 patients (in 2 cases of recurrent pancreatitis the tubes were placed again after extubation).Besides the use of regular fasting,antacids,inhibitors of trypsin secretion,and anti-infective treatment,23 cases of all children got nasojejunal nutrition treatment as well.The outcome measures included the success rate,complications of endoscope-assisted nasojejunal tube placement.The children's tolerance and nutrition indicators (weight,blood lymphocytes count,erythrocytes count,serum albumin,serum creatinine,blood urea nitrogen) were observed before and after enteral nutrition therapy.Result Malnutrition evaluation was done 24 times before treatment among 22 patients,incidence of malnutrition was 33% in 22 cases.Placement of nasojejunal tube placement was attempted for a total of 24 times and was successful on first placement in 22 cases,in two cases the placement was successful on the second placement,so the success rate of the first attempt for placement was 92%.No significant complications were observed in any of the cases.Twenty-three of 24 cases were given standardized enteral nutrition (one case was not given enteral nutrition therapy but underwent ERCP due to obstructive jaundice).Twenty-two of 23 cases could tolerate enteral nutrition well,only 1 case was unable to tolerate enteral nutrition due to the pancreas schizophrenia,paralytic ileus

  5. Getting Real: A General Chemistry Laboratory Program Focusing on "Real World" Substances (United States)

    Kerber, Robert C.; Akhtar, Mohammad J.


    compare results with their classmates by use of a flip chart on which the results are summarized. Their purpose the first week is to identify one or two classmates who share the same sample. The second week, authentic samples are provided, and the teams identify their common unknown by comparison of its properties with the knowns. We encourage final comparison to be on a quantitative basis. 2. In "Properties of Antifreeze-Water Mixtures", each student is assigned a weight percent and prepares a mixture of ethylene glycol and water of that composition. He or she then measures its initial boiling point, density, and viscosity (falling ball method). The class data are entered into spreadsheets and printouts of all class data are provided before the students leave. The second week, they are given an unknown mixture and determine its composition by whatever measurements they choose to use, in comparison with the aggregated class data. Despite large scatter in the class data, 80% of the students identify the unknown composition to within 5%. 3. In the three-week group of exercises dealing with aspirin, students synthesize a sample of aspirin the first week by a standard method. During the next two weeks, they analyze their product and commercial samples by two different methods, which allows comparison of convenience and reliability of the two methods as well as comparison of the samples themselves. Similarly, two complementary methods are used in determining calcium in antacids later on. 4. In "Identification of Plastics", plastic packaging materials, identified initially by their recycling codes, are characterized according to density, solubility, and responses to heating. The behavioral profiles are then used to identify unknown plastic samples. 5. Similarly, in "Textiles and Dyeing", samples of six common fibers, both natural and human-made, are subjected to a battery of tests involving elemental composition, chemical behavior, solubility in organic solvents, and response