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Prashant Singh, Braden Kuo
Nausea and vomiting result from continuous interactions among gastrointestinal, central nervous system, and autonomic nervous system. Despite being closely associated, central pathways of nausea and vomiting appear to be at least partly different and nausea is no longer considered only a penultimate step of vomiting. Although our understanding of central pathways of nausea has improved over the last one decade, it is still very basic. Afferent pathways from gastrointestinal tract via vagus, vestibular system, and chemoreceptor trigger zone project to nucleus tractus solitarius which, in turn, relays the signal to central pattern generator initiating multiple downstream pathways...
October 12, 2016: Current Treatment Options in Gastroenterology
Joong Seok Kim, Dong Woo Ryu, Ju Hee Oh, Yang Hyun Lee, Sung Jin Park, Kipyung Jeon, Jong Yun Lee, Seong Hee Ho, Jungmin So, Jin Hee Im, Kwang Soo Lee
BACKGROUND AND PURPOSE: Recent studies have shown that several nonmotor symptoms differ between Parkinson's disease (PD) and drug-induced parkinsonism (DIP). However, there have been no reports on cardiovascular autonomic function in DIP, and so this study investigated whether cardiovascular autonomic function differs between PD and DIP patients. METHODS: This study consecutively enrolled 20 DIP patients, 99 drug-naïve PD patients, and 25 age-matched healthy controls who underwent head-up tilt-table testing and 24-h ambulatory blood pressure monitoring...
October 7, 2016: Journal of Clinical Neurology
Stephen Flach, Marie Croft, Jie Ding, Ron Budhram, Todd Pankratz, Mike Pennick, Graeme Scarfe, Steven Troy, Jay Getsy
PURPOSE: Gastroesophageal reflux disease involves the reflux of gastric and/or duodenal content into the esophagus. Prokinetic therapies, such as the selective 5-hydroxytryptamine receptor 4 agonist revexepride, may aid gastric emptying. This Phase I study evaluated the pharmacokinetics and excretion pathways of [(14)C]revexepride in healthy individuals using a microtracer approach with accelerator mass spectrometry. PARTICIPANTS AND METHODS: Six healthy men received a single oral dose of 2 mg [(14)C]revexepride containing ~200 nCi of radioactivity; blood, urine, and fecal samples were collected over a 10-day period...
2016: Drug Design, Development and Therapy
William L Hasler
Chronic unexplained nausea and vomiting (CUNV) refers to a symptom complex defined by nausea and/or vomiting with normal diagnostic testing, including anatomic assessments (including upper endoscopy) and measures of upper gut function (e.g., gastric emptying testing). Nausea and vomiting in this condition are postulated to result from aberrant peripheral or central neurohumoral activity. A substantial subset of patients satisfies this diagnosis as more than half of individuals referred for scintigraphic testing exhibit normal gastric emptying rates...
October 10, 2016: Current Treatment Options in Gastroenterology
Shinsuke Nakayama, Hidemi Teramoto
 The umami taste amino acid, glutamate acts as a signaling molecule in multiple cellular systems in the body, including the brain and gastrointestinal tract. Therefore, glutamate may affect appetite by modulating gastrointestinal motility as well as through taste perception. In this study, we examined the effect of glutamate on gastric emptying and duodenal motility, by using rapid magnetic resonance imaging (MRI). Ten healthy male volunteers participated in the measurements. Abdominal coronal MR images were successively acquired after ingestion of a liquid meal with and without monosodium L-glutamate (MSG)...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Min Cheol Lee, Wooram Ha, Jinhyeong Park, Junghoon Kim, Yunjin Jung, Byung Joo Kim
AIM: To investigate the effects of Lizhong Tang, a traditional Chinese medicine formula, on gastrointestinal motility in mice. METHODS: The in vivo effects of Lizhong Tang on GI motility were investigated by measuring the intestinal transit rates (ITRs) and gastric emptying (GE) values in normal mice and in mice with experimentally induced GI motility dysfunction (GMD). RESULTS: In normal ICR mice, the ITR and GE values were significantly and dose-dependently increased by Lizhong Tang (ITR values: 54...
September 14, 2016: World Journal of Gastroenterology: WJG
Arthur Raymond Hubert van Zanten
Gastrointestinal feeding intolerance and critical illness-associated gastric motility dysfunction are common. Although recent guidelines recommend not interrupting gastric feeding when gastric residual volume (GRV) is lower than 500 mL or to completely abandon measurement of GRV, it may seem that the relevance of prokinetics is reduced.In patients at risk for aspiration and in multimodal strategies to enhance feeding performance, however, use of prokinetics is still advocated. Metoclopramide and erythromycin are commonly used promotility agents, although with relevant side effects...
September 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
Sei-Ichi Nakano, Hidetaka Iwasaki, Eiji Kondo, Katsushi Miyazaki, Haruhiko Shizuku, Sei-Ichiro Kamimura, Junya Fukuda, Ryo Kanamura, Noriaki Takeda
OBJECTIVE: Globus pharyngeus (GP) is a common symptom of laryngopharyngeal reflux disease (LPRD), and proton pump inhibitor (PPI) and rikkunshito, a traditional Japanese medicine having prokinetic effect improve LPRD symptoms. In the present study, we examined the efficacy of high-dose PPI in combination with rikkunshito in patients complaining of GP. METHODS: 106 patients complaining of GP without any organic endoscopic findings were enrolled. RESULTS: Patients were first administrated with high-dose PPI alone for 4 to 8 weeks and the symptom was improved in 65 patients...
2016: Journal of Medical Investigation: JMI
Akihito Fujimi, Hiroki Sakamoto, Yuji Kanisawa, Shinya Minami, Yasuhiro Nagamachi, Naofumi Yamauchi, Soushi Ibata, Junji Kato
A 55-year-old man with several comorbidities including idiopathic interstitial pneumonia under long-term corticosteroid therapy, longstanding myocardial infarction, chronic heart failure, paroxysmal atrial fibrillation, gastro-esophageal reflux disease, constipation, and history of paralytic ileus, was diagnosed with chronic myelogenous leukemia (CML) in the chronic phase. He also tested positive for anti-topoisomerase I antibodies without clinical diagnosis of any connective tissue disease, including systemic sclerosis...
September 16, 2016: Clinical Journal of Gastroenterology
Wojciech Leppert, Jaroslaw Woron
Opioid-induced constipation (OIC) and other gastrointestinal (GI) symptoms of opioid-induced bowel dysfunction (OIBD) significantly deteriorate patients' quality of life and may lead to noncompliance with opioid schedule and undertreatment of pain. Although traditional oral laxatives are the first-line treatment of OIC, they do not address OIBD pathophysiology, and display numerous adverse effects. OIC treatment includes prokinetics (lubiprostone), opioid switch, and changing route of opioid administration...
September 2016: Therapeutic Advances in Gastroenterology
Weisheng Chen, Cheng Sun, Ru Wei, Yanlin Zhang, Heng Ye, Ruibin Chi, Yichen Zhang, Bei Hu, Bo Lv, Lifang Chen, Xiunong Zhang, Huilan Lan, Chunbo Chen
BACKGROUND: Despite the use of prokinetic agents, the overall success rate for postpyloric placement via a self-propelled spiral nasoenteric tube is quite low. METHODS: This retrospective study was conducted in the intensive care units of 11 university hospitals from 2006 to 2016 among adult patients who underwent self-propelled spiral nasoenteric tube insertion. Success was defined as postpyloric nasoenteric tube placement confirmed by abdominal x-ray scan 24 hours after tube insertion...
August 31, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Makoto Komura, Yutaka Kanamori, Yujiro Tanaka, Tetsuro Kodaka, Masahiko Sugiyama, Kan Terawaki, Kan Suzuki, Tadashi Iwanaka
BACKGROUND: The prokinetic agent cisapride is effective for the treatment of GERD in infants and children, but is no longer used for this purpose because of safety concerns. Therefore, other pharmacological agents need to be investigated for their efficacy in the treatment of patients with GERD. In this study, we examined the effectiveness and safety of mosapride for the treatment of neurologically impaired children and adolescents with GERD. METHODS: Mosapride (0...
August 26, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Francisco Javier García Callejo, Jaume Redondo Martínez, Tomás Pérez Carbonell, Rafael Monzó Gandía, M Paz Martínez Beneyto, Inés Rincón Piedrahita
INTRODUCTION: Hiccup crises are generally benign and self-limiting, but longer episodes affect quality of life and must be treated. There are recognisable causes that otorhinolaryngologists must know and be aware for diagnosis and therapeutic alternatives. The main expression is a spasmodic glottic noise with characteristic neck alterations. PATIENTS AND METHODS: This was a retrospective study from 1979 with patients suffering persistent or recurrent hiccups. Chronobiology, comorbidity, findings from explorations, therapies and outcomes were noted...
August 16, 2016: Acta Otorrinolaringológica Española
Ikumi Ishibashi-Shiraishi, Seiji Shiraishi, Shinichi Fujita, Saori Ogawa, Masahiko Kaneko, Manabu Suzuki, Tatsuro Tanaka
Amino acids are not only constituents of proteins, but also have multiple physiologic functions. Recent findings have revealed that ingested amino acids either activate luminal receptors or are metabolized, causing physiologic reactions in the gastrointestinal (GI) tract. We examined the effect of oral L-arginine L-glutamate (ArgGlu), a pharmaceutical amino acid salt used i.v. for the treatment of hyperammonemia, on gastric motor function in rats and dogs. Gastric emptying was determined using phenol red and (13)C-breath test methods, whereas gastric relaxation was determined using the barostat method...
November 2016: Journal of Pharmacology and Experimental Therapeutics
Kim Lewis, Zuhoor Alqahtani, Lauralyn Mcintyre, Saleh Almenawer, Fayez Alshamsi, Andrew Rhodes, Laura Evans, Derek C Angus, Waleed Alhazzani
BACKGROUND: Intolerance to enteral nutrition is common in critically ill adults, and may result in significant morbidity including ileus, abdominal distension, vomiting and potential aspiration events. Prokinetic agents are prescribed to improve gastric emptying. However, the efficacy and safety of these agents in critically ill patients is not well-defined. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy and safety of prokinetic agents in critically ill patients...
2016: Critical Care: the Official Journal of the Critical Care Forum
A A Sheptulin, I B Belousova
The importance of prokinetics (drugs stimulating motor function of the gastrointestinal tract) arises from the high prevalence of gastroenterological pathology associated with primary or secondary disturbances of this function in esophagus, stomach, and intestines. The main groups of prokinetics are beta-blockers of dopamine receptors, inhibitors of acetylcholine esterase (or their combination with dopamine receptor blockers), 5-HT4-receptor agonists. They find wide application for the treatment of gastroesophgeal reflux disease, functional dyspepsia and constipation, obstipational form of irritable bowel syndrome, and other conditions accompanied by motor function disorders of the gastrointestinal tract...
2016: Klinicheskaia Meditsina
Stefan Wirz, Steffen Simon, Thomas Frieling, Claudia Bausewein, Raymond Voltz, Anne Pralong, Stefan Mönig, Markus Follmann, Martin Holtmann, Gerhild Becker
According to the German S3-guideline 'Palliative Medicine' which has been supported by the German Guideline Program in Oncology, constipation in palliative patients requires a consistent prophylaxis and therapy. Constipation is caused by immobilisation, poor health, exsiccosis, a low-fiber diet or a preexisting functional constipation. Further important causes are substances with constipating side effects, such as opioids or anticholinergic drugs. Pragmatically, constipation should be assessed by subjective parameters such as the feeling of incomplete evacuation, straining, or other complaints...
August 2016: Deutsche Medizinische Wochenschrift
Brian Speer, Lauren Virginia Powers
Cranial kinesis of the avian beak is complex; particularly in birds with prokinetic beak movement, such as psittacine birds. A number of diseases can result in damage to the bony and soft tissue structures of the beak and can lead to secondary pathology, such as beak deviation, abnormal rhamphothecal growth and wear, and opportunistic infections. A solid understanding of species-specific anatomic variations is essential before attempting rhamphothecal restoration or surgical repair. Many diseases of the oral cavity can appear similar on initial clinical evaluation and therefore warrant appropriate diagnostic testing...
September 2016: Veterinary Clinics of North America. Exotic Animal Practice
Hui Chen, Feng Hong, Ye Chen, Ji Li, Yuan-Sheng Yao, Yue Zhang, Li-Fei Zheng, Jin-Xia Zhu
Mosapride, a gastrointestinal prokinetic drug, is an agonist of 5-hydroxytryptamine (5-HT) receptor 4 that also reduces blood glucose. Whether 5-HT4 receptor is distributed in pancreatic islets and whether mosapride can directly stimulate insulin secretion is unclear. In the present study, the protein expression and cellular location of 5-HT4 receptor in pancreas was detected through western blotting and immunofluorescence. The acute effects of 5-HT4 receptor agonists, mosapride and prucalopride, on insulin secretion were investigated in vivo and in vitro in normal and alloxan-induced diabetes rats...
October 15, 2016: European Journal of Pharmacology
Jieyun Yin, Xiaohong Xu, Gengqing Song, Hyun Sil Han, Hong Wook Kim, Jiande D Z Chen
BACKGROUND AND AIM: Prokinetics have been considered the first-line medicine for treating delayed gastric emptying. The aim of this study was to explore effects and mechanisms of a new 5-HT4 receptor agonist, YKP10811 on gastric motility in dogs. METHODS: Four experiments were performed in dogs: 1) dose-response effects of YKP10811 on liquid gastric emptying; 2) effects and mechanisms of YKP10811 on solid gastric emptying delayed by glucagon; 3) effects of low dose YKP10811 on antral contractions; 4) effects of low dose YKP10811 on gastric accommodation...
July 15, 2016: Journal of Gastroenterology and Hepatology
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