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Konstantinos Denaxas, Spyros D Ladas, George P Karamanolis
Systemic sclerosis (SSc) is a multisystemic autoimmune connective tissue disorder; in the gastrointestinal tract, the esophagus is the most commonly affected organ. Symptoms of esophageal disease are due to gastroesophageal reflux disease (GERD) and esophageal motor dysfunction. Since the development of high-resolution manometry (HRM), this method has been preferred for the study of SSc patients with esophageal involvement. Using HRM, classic scleroderma esophagus, defined as absent or ineffective peristalsis of the distal esophagus in combination with a hypotensive lower esophageal sphincter, was found in as many as 55% of SSc patients...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of 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...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Tadashi Tsubouchi, Takeshi Kunimatsu, Shinji Tsujimoto, Akihiko Kiyoshi, Yasunori Katsura, Seiko Oku, Kazuhiro Chihara, Yukiko Mine, Toru Yamada, Isao Shimizu, Kiyoko Bando
The pharmacological activity of DSP-6952, a novel compound was investigated, compared to that of clinically efficacious gastrointestinal (GI) prokinetic 5-hydroxytryptamine4 (5-HT4 ) receptor agonists. DSP-6952 had a strong affinity of Ki=51.9nM for 5-HT4(b) receptor, and produced contraction in the isolated guinea pig colon with EC50 of 271.6nM and low intrinsic activity of 57%, similar to tegaserod and mosapride. In the development of the 5-HT4 receptor agonists, cardiovascular risk was deliberately evaluated, because some related prokinetics were reported to cause with cardiovascular adverse events, such as ventricular arrhythmias or ischemia...
March 1, 2018: European Journal of Pharmacology
Ovadyah Avraham, Michael Biglow
BACKGROUND: Deprescribing is a recommended intervention to reduce morbidity and mortality caused by polypharmacy in older residents. However, a lack of definite deprescription guidelines and evidence of clinically meaningful outcomes complicates or precludes the practicality of such an approach. OBJECTIVE: The objective of the present pilot study is to establish and implement a stepwise taper protocol that can potentially minimize overuse of proton pump inhibitors in a safe, effective, and feasible manner in the nursing home...
February 1, 2018: Annals of Pharmacotherapy
J R Giudicessi, M J Ackerman, M Camilleri
BACKGROUND: Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use...
February 14, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Shaheen Sultana, Sushma Talegaonkar, Bhaskar Ray, Harvinder Singh, F J Ahmad, Gaurav Mittal, Aseem Bhatnagar
INTRODUCTION: In this study, different nifedipine-loaded formulations were prepared to treat pylorospasm, a sphincter muscle disorder characterized by delayed gastric emptying process. The efficacy of formulation was evaluated in patients by subjective assessment, gamma scintigraphic approaches, and confocal microscopy. METHODS: Nifedipine-loaded different formulations such as sucrose bead, pellets, and microparticles (slugging method, ionotropic gelation, and chemical denaturation) were designed...
February 21, 2018: Drug Development and Industrial Pharmacy
Yukiko Mine, Tomohiro Itakura, Seiko Oku, Reiko Asada, Isao Shimizu
The pharmacological profile of DSP-6952, a novel 5-HT4 receptor partial agonist, was investigated to evaluate the potential use for GI disorders, and to compare its effects in some GI dysfunction models with those of clinically efficacious prokinetic agents. DSP-6952 enhanced gastric motility and caused colonic giant migrating contractions (GMCs) associated with defecation in conscious dogs, having ED50 value for inducing GMCs of 1.56mg/kg. DSP-6952 (3-10mg/kg, i.g.) significantly enhanced colonic transit rate in guinea pigs; this enhancement was antagonized by SB-207266, a selective 5-HT4 receptor antagonist...
February 8, 2018: European Journal of Pharmacology
Rosalie Yandell, Marianne Chapman, Stephanie O'Connor, Alison Shanks, Kylie Lange, Adam Deane
AIM: To determine whether the placement of a post-pyloric feeding tube (PPFT) can be taught safely and effectively to a critical care dietitian. METHODS: This is a prospective observational study conducted in an adult intensive care unit (ICU). The intervention consisted of 19 attempts at post-pyloric intubation by the dietitian. The 10 'learning' attempts were performed by the dietitian under the direction of an experienced (having completed in excess of 50 successful tube placements) user...
February 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
Azjargal Enkhsaikhan, Akira Takahara, Yuji Nakamura, Ai Goto, Koki Chiba, Nur Jaharat Lubna, Mihoko Hagiwara-Nagasawa, Hiroko Izumi-Nakaseko, Kentaro Ando, Atsuhiko T Naito, Atsushi Sugiyama
A beverage made of red wine vinegar and grape juice (Yamanashi-no-megumi™) was developed as a supplemental fluid containing polyphenols, which has been clinically shown to enhance the colonic transit. In this study, we assessed the mechanism of its prokinetic action by analyzing the effects on both the colonic phosphodiesterase activity of rats (n=4) and the isolated colonic strip preparation of guinea pigs (n=4). The 7% (v/v) solution of the beverage significantly decreased the phosphodiesterase activity by 9% (n=4)...
2018: Biological & Pharmaceutical Bulletin
Mika Seto, Sayo Koga, Ryosuke Kita, Toshihiro Kikuta
QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively...
December 2017: Journal of Dental Anesthesia and Pain Medicine
Hiroshi Yamawaki, Seiji Futagami, Mako Wakabayashi, Noriko Sakasegawa, Shuhei Agawa, Kazutoshi Higuchi, Yasuhiro Kodaka, Katsuhiko Iwakiri
Patients with functional dyspepsia, defined in the 2016 Rome IV criteria as bothersome clinical dyspepsia symptoms, experience markedly reduced quality of life. Several etiologies have been associated with the disorder. In the Rome IV criteria, the brain-gut axis was acknowledged as an important factor in the etiology of functional gastrointestinal (GI) disorders. The distinct subgroups of functional dyspepsia, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), are treated differently: acid secretion inhibitors are recommended with patients with EPS, whereas prokinetic drugs as mosapride and acotiamide are recommended for patients with PDS...
January 2018: Therapeutic Advances in Chronic Disease
Aroosa Ishtiaq Butt, Bushra Tayyaba Khan, Asma Khan, Qamar-Uz-Zaman Khan
BACKGROUND: Gastroparesis and GERD occur concomitantly in 40 percent of the cases. Prokinetic drugs and acid blockers are employed as the main treatment modality. Ranitidine is an acid blocker with additional prokinetic activity and Itopride is a known prokinetic drug. This study was designed to observe the synergistic potentiating prokinetic effect of Ranitidine on itopride on isolated duodenum of rabbits. METHODS: Ranitidine (10-5-10-3) and itopride (10-6-10-5) were added in increasing concentrations to isolated duodenum of rabbits and contractions were recorded on PowerLab Data acquisition unit AHK/214...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
Iksung Kim, Jinsoo Bae, Byung Joo Kim
Background: Gastrointestinal (GI) symptoms are common in the general population. This investigation studied the effects of Carthami flos (CF), a natural product, on GI motility. Methods: We checked the intestinal transit rates (ITRs) or gastric emptying in normal and in GI-motility-dysfunction (GMD) mice in vivo. The GMD mice were made by acetic acid or streptozotocin. Results: Both ITRs and gastric emptying were increased by CF (0.0025-0...
December 2017: Integrative medicine research
Yongwoo Jang, Eun-Kyung Kim, Won-Sik Shim
Poncirus trifoliata (L.) Raf. belongs to the family Rutaceae in the genus Poncirus. Its fruits are widely used to alleviate symptoms of various disorders. The mature fruit (MF) possesses anticancer and antiinflammatory activities. Extracts of the dried, immature fruit, Poncirus fructus (PF) are widely used as a traditional medicine for ameliorating symptoms of digestive dysfunction in East Asia. Molecular and cellular mechanisms underlying the effects of MF and PF extracts on cancer, inflammation, and gastrointestinal disorders have been extensively studied in the past decade...
December 18, 2017: Phytotherapy Research: PTR
Lesley Marson, Karl B Thor, Mary Katofiasc, Edward C Burgard, Nadia M J Rupniak
The suitability of various neurokinin-2 (NK2) receptor agonists and routes of administration to elicit on-demand voiding of the bladder and bowel, as future therapy for individuals with spinal cord injury, was examined using a rat model. The current study examined the feasibility of alternative routes of administration, which are more practical for clinical use than intravenous (IV) administration. Voiding and isovolumetric cystometry were recorded in anesthetized, acutely spinalized, female rats after IV, subcutaneous (SC), intramuscular (IM), intranasal (IN), or sublingual (SL) administration of [Lys5,MeLeu9,Nle10]-NKA(4-10] (LMN-NKA)...
December 10, 2017: European Journal of Pharmacology
Hamidreza T Masoumi, Molouk Hadjibabaie, Morvarid Zarif-Yeganeh, Behrouz Khajeh, Ardeshir Ghavamzadeh
Introduction Acute lymphoblastic leukemia is an invasive malignancy which ought to be treated with several cytotoxic medications. Vincristine-based regimen is among the most commonly used regimens for the treatment of adult acute lymphoblastic leukemia. Peripheral neuropathy caused by vincristine provides a limitation in dose administration and can influence the treatment outcome and patient's quality of life. Case presentation Ileus and constipation occurred as a result of autonomic neuropathy in a 58-year-old man who underwent vincristine-based regimen for acute lymphoblastic leukemia treatment...
January 1, 2017: Journal of Oncology Pharmacy Practice
Michael Mcfarlane, B Liu, C Nwokolo
PURPOSE: Domperidone is thought to accelerate gastric emptying via D2 receptor antagonism at the gastro-oesophageal and gastro-duodenal junctions. Listed in the BNF as a prokinetic anti-emetic, it has been used in video capsule endoscopy (VCE) to accelerate capsule delivery to the small intestine. We audited VCEs performed at UHCW from 2011, when as standard practice, domperidone was given pre-VCE, to 2012, after its discontinuation due to doubts about its effectiveness. METHODS: Thirty-one patients received oral domperidone 20 mg pre-VCE...
December 8, 2017: European Journal of Clinical Pharmacology
E M Besecker, A R White, G M Holmes
BACKGROUND: Patients with cervical or high-thoracic spinal cord injury (SCI) often present reduced gastric emptying and early satiety. Ghrelin provokes motility via gastric vagal neurocircuitry and ghrelin receptor agonists offer a therapeutic option for gastroparesis. We have previously shown that experimental high-thoracic injury (T3-SCI) diminishes sensitivity to another gastrointestinal peptide, cholecystokinin. This study tests the hypothesis that T3-SCI impairs the vagally mediated response to ghrelin...
December 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Daniela S Andres, Olivier Darbin
The rate and oscillatory hypotheses are the two main current frameworks of basal ganglia pathophysiology. Both hypotheses have emerged from research on movement disorders sharing similar conceptualizations. These pathological conditions are classified either as hypokinetic or hyperkinetic, and the electrophysiological hallmarks of basal ganglia dysfunction are categorized as prokinetic or antikinetic. Although nonmotor symptoms, including neurobehavioral symptoms, are a key manifestation of basal ganglia dysfunction, they are uncommonly accounted for in these models...
November 29, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
Maria Ines Pinto-Sanchez, Yuhong Yuan, Ahmed Hassan, Premysl Bercik, Paul Moayyedi
BACKGROUND: Functional dyspepsia (FD or non-ulcer dyspepsia) is defined as continuous or frequently recurring epigastric pain or discomfort for which no organic cause can be found. Acid suppressive therapy, including proton pump inhibitors (PPIs), has been proposed as a therapeutic option in FD, but its efficacy remains controversial. While PPIs are generally considered safe and well tolerated, they have been associated with adverse events, especially in the long term. For this reason, decisions on whether to initiate or continue PPI therapy should be made based on an appropriate clinical indication...
November 21, 2017: Cochrane Database of Systematic Reviews
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