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https://www.readbyqxmd.com/read/28633671/preliminary-safety-and-efficacy-profile-of-prucalopride-in-the-treatment-of-systemic-sclerosis-ssc-related-intestinal-involvement-results-from-the-open-label-cross-over-progass-study
#1
Barbara Vigone, Monica Caronni, Adriana Severino, Chiara Bellocchi, Anna Rita Baldassarri, Mirella Fraquelli, Gaia Montanelli, Alessandro Santaniello, Lorenzo Beretta
BACKGROUND: Prokinetics are used to treat enteric dismotility symptoms in systemic sclerosis (SSc) patients, but they often lack adequate efficacy. The most effective prokinetics belonging to the serotonin (5-HT4) receptor agonists class were withdrawn due to cardiac toxicity in relation to modest 5-HT4 receptor affinity. Prucalopride is a high-affinity 5-HT4 receptor agonist with no major cardiac issues, for which the efficacy in SSc has not yet been assessed. METHODS: Forty patients with self-reported mild to moderately severe enteric symptoms were enrolled in a cross-over 2 × 2 study...
June 20, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28631728/acg-and-cag-clinical-guideline-management-of-dyspepsia
#2
Paul M Moayyedi, Brian E Lacy, Christopher N Andrews, Robert A Enns, Colin W Howden, Nimish Vakil
We have updated both the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) guidelines on dyspepsia in a joint ACG/CAG dyspepsia guideline. We suggest that patients ≥60 years of age presenting with dyspepsia are investigated with upper gastrointestinal endoscopy to exclude organic pathology. This is a conditional recommendation and patients at higher risk of malignancy (such as spending their childhood in a high risk gastric cancer country or having a positive family history) could be offered an endoscopy at a younger age...
June 20, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28605740/a-randomized-double-blind-pilot-study-of-the-effect-of-famotidine-on-acotiamide-treatment-for-functional-dyspepsia
#3
Mariko Hojo, Akihito Nagahara, Daisuke Asaoka, Tsutomu Takeda, Kentaro Izumi, Kohei Matsumoto, Hiroya Ueyama, Yuji Shimada, Kenshi Matsumoto, Shuko Nojiri, Sumio Watanabe
BACKGROUND/AIMS: Acotiamide, a prokinetic drug, is used to treat functional dyspepsia (FD), especially postprandial distress syndrome (PDS). However, a treatment for FD patients with PDS and/or epigastric pain syndrome (EPS) has not been established. We investigated the efficacy of famotidine in combination with acotiamide for FD. METHODS: Fifty blindly randomized FD patients received placebo with acotiamide, or famotidine with acotiamide, for 4 weeks. Treatment efficacy was assessed by overall treatment effects (OTE), total, PDS and EPS symptom scores, and impairment of quality of life (QOL)...
June 13, 2017: Digestion
https://www.readbyqxmd.com/read/28602752/analysis-of-complications-of-prone-position-in-acute-respiratory-distress-syndrome-quality-standard-incidence-and-related-factors
#4
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#5
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
June 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28601331/risk-factors-for-delayed-gastric-emptying-in-patients-undergoing-esophagectomy-without-pyloric-drainage
#6
Lei Zhang, Sheng-Cai Hou, Jin-Bai Miao, Hui Lee
BACKGROUND: The incidence of delayed gastric emptying (DGE) after esophagectomy is 10%-50%, which can interfere with postoperative recovery in the short-term and result in poor quality of life in the long term. Pyloric drainage is routinely performed to prevent DGE, but its role is highly controversial. The aim of this study was to report the rate of DGE after esophagectomy without pyloric drainage and to investigate its risk factors and the potential effect on recovery. MATERIALS AND METHODS: Between January 2010 and January 2015, we analyzed 285 consecutive patients who received an esophagectomy without pyloric drainage...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28597805/efficacy-of-sequential-three-step-empirical-therapy-for-chronic-cough
#7
Li Yu, Xianghuai Xu, Jingqing Hang, Kewen Cheng, Xiaoyan Jin, Qiang Chen, Hanjing Lv, Zhongmin Qiu
BACKGROUND: Empirical three-step therapy has been proved in just one hospital. This study aimed to demonstrate applicability of the sequential empirical three-step therapy for chronic cough in different clinical settings. METHODS: Sequential empirical three-step therapy was given to patients with chronic cough in one tertiary and three secondary care respiratory clinics. Recruiters were initially treated with methoxyphenamine compound as the first-step therapy, followed by corticosteroids as the second-step therapy and the combination of a proton-pump inhibitor and a prokinetic agent as the third-step therapy...
June 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28588875/management-of-chronic-constipation-in-adults
#8
REVIEW
K Krogh, G Chiarioni, W Whitehead
Chronic constipation (CC) is an extremely common condition with an estimated prevalence of up to 24%. Most patients with CC should be treated in primary care. Changes in lifestyle, including increased intake of dietary fibre, fluid, and exercise, should be attempted in most patients. Osmotic or stimulant laxatives are indicated if there are insufficient effects of lifestyle changes. Prokinetics and secretagogues should be restricted to those not responding to basic treatment. Anorectal physiology tests and assessment of colorectal transit time are indicated if medical treatment fails or if symptoms indicate severely obstructed defecation...
June 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28577245/from-harmful-treatment-to-secondary-gain-adverse-event-reporting-in-dyspepsia-and-gastroparesis
#9
Klaus Bielefeldt
INTRODUCTION: Medical management of gastroparesis and functional dyspepsia remains difficult with several recent trials showing limited or no benefit. If treatment comes with only marginal improvements, concerns about adverse events become more relevant. We therefore examined the type and outcomes of side effects submitted to a public repository. METHODS: We searched the Federal Adverse Event Reporting System for reports associated with the treatment of dyspepsia or gastroparesis...
June 2, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28565806/prokinetic-effects-of-ld02gifro-on-functional-gastrointestinal-disorder-in-rats
#10
Myung-Joo Choi, Hong-Mei Zheng, Hee Dong Park, Hee Kyung Jeong, Soon-Sun Hong, Jae Min Kim, Don Haeng Lee
LD02GIFRO is a novel prokinetic agent formulated with Poncirus fructus and Zanthoxylum sp. fruits. The aim of the present study was to evaluate the effect of LD02GIFRO on delayed gastrointestinal transit (GIT) and colorectal hypersensitivity. To investigate the effect of LD02GIFRO, a rat model of delayed GIT was induced via three mechanisms; postoperative ileus (POI), morphine, and POI plus morphine. Visceromotor responses (VMR) to colorectal distension (CRD) were also evaluated. POI was induced by laparotomy surgery and manipulation of the small intestine under anesthesia, and GIT was calculated by measuring the length that Evans Blue travelled through the gastrointestinal tract in a given time...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28535580/gastroparesis-updates-on-pathogenesis-and-management
#11
REVIEW
Nanlong Liu, Thomas Abell
Gastroparesis (Gp) is a chronic disease that presents with clinical symptoms of early satiety, bloating, nausea, vomiting, and abdominal pain. Along with these symptoms, an objective finding of delayed gastric emptying, along with a documented absence of gastric outlet obstruction, are required for diagnosis. This article focuses on updates in the pathogenesis and management of Gp. Recent studies on full thickness biopsies of Gp patients have shed light on the complex interactions of the central, autonomic, and enteric nervous systems, which all play key roles in maintaining normal gut motility...
May 25, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28531392/a-randomised-controlled-feasibility-and-proof-of-concept-trial-in-delayed%C3%A2-gastric-emptying-when-metoclopramide-fails-we-should-revisit%C3%A2-nasointestinal-feeding-versus-dual-prokinetic-treatment-achieving-goal-nutrition-in-critical-illness-and-delayed-gastric
#12
Stephen J Taylor, Kaylee Allan, Helen McWilliam, Alex Manara, Jules Brown, Rosemary Greenwood, Deirdre Toher
BACKGROUND & AIMS: Delayed gastric emptying (DGE) commonly limits the use of enteral nutrition (EN) and may increase ventilator-associated pneumonia. Nasointestinal feeding has not been tested against dual prokinetic treatment (Metoclopramide and Erythromycin) in DGE refractory to metoclopramide. This trial tests the feasibility of recruiting this 'treatment-failed' population and the proof of concept that nasointestinal (NI) feeding can increase the amount of feed tolerated (% goal) when compared to nasogastric (NG) feeding plus metoclopramide and erythromycin treatment...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529530/chai-qin-cheng-qi-decoction-and-carbachol-improve-intestinal-motility-by-regulating-protein-kinase-c-mediated-ca-2-release-in-colonic-smooth-muscle-cells-in-rats-with-acute-necrotising-pancreatitis
#13
Chen-Long Zhang, Zi-Qi Lin, Rui-Jie Luo, Xiao-Xin Zhang, Jia Guo, Wei Wu, Na Shi, Li-Hui Deng, Wei-Wei Chen, Xiao-Ying Zhang, Shameena Bharucha, Wei Huang, Robert Sutton, John A Windsor, Ping Xue, Qing Xia
Chai-Qin-Cheng-Qi decoction (CQCQD) improves intestinal motility in acute pancreatitis (AP), but the mechanism(s) require elucidation. We investigated the effects of CQCQD and carbachol, a prokinetic agent, on colonic smooth muscle cells (SMCs) in L-arginine-induced necrotising AP model in rats. In treatment groups, intragastric CQCQD (20 g/kg, 2 hourly × 3 doses) or intraperitoneal carbachol (60 μg/kg) was given 24 hours after induction of AP. Both CQCQD and carbachol decreased the severity of pancreatic and colonic histopathology (all P < 0...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28526488/-targeting-the-gut-liver-axis-in-liver-disease
#14
REVIEW
Reiner Wiest, Agustin Albillos, Michael Trauner, Jashmohan Bajaj, Rajiv Jalan
The gut is open to the outer environment, harbours the microbiome containing several fold more genetic material than the human genome and produces a myriad of metabolites as well as hormones/peptides. The liver is at the nexus between this vast source of nutrients, toxins and hormones and the remaining human body. Not surprisingly, this liver-gut-axis has hence, been demonstrated in experimental models and in-vitro systems to contribute to the pathogenesis of most liver diseases such as alcoholic and non-alcoholic fatty liver disease (NAFLD), -steatohepatitis (NASH), cholestatic liver diseases, hepatocellular carcinoma, acute-on-chronic liver failure, progression to fibrosis/cirrhosis and complications of cirrhosis...
May 16, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28516373/class-side-effects-decreased-pressure-in-the-lower-oesophageal-and-the-pyloric-sphincters-after-the-administration-of-dopamine-antagonists-neuroleptics-anti-emetics-l-name-pentadecapeptide-bpc-157-and-l-arginine
#15
Zeljka Belosic Halle, Josipa Vlainic, Domagoj Drmic, Dean Strinic, Kresimir Luetic, Mario Sucic, Maria Medvidovic-Grubisic, Tatjana Pavelic Turudic, Igor Petrovic, Sven Seiwerth, Predrag Sikiric
The ulcerogenic potential of dopamine antagonists and L-NAME in rats provides unresolved issues of anti-emetic neuroleptic application in both patients and experimental studies. Therefore, in a 1-week study, we examined the pressures within the lower oesophageal and the pyloric sphincters in rats [assessed manometrically (cm H2O)] after dopamine neuroleptics/prokinetics, L-NAME, L-arginine and stable gastric pentadecapeptide BPC 157 were administered alone and/or in combination. Medication (/kg) was given once daily intraperitoneally throughout the 7 days, with the last dose at 24 h before pressure assessment...
May 17, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28514401/-differentiation-therapy-for-non-acidic-gastroesophageal-reflux-disease
#16
N B Lishchuk, V I Simanenkov, S V Tikhonov
AIM: To investigate the clinical and pathogenetic features of the non-acidic types of gastroesophageal reflux disease (GERD) and to evaluate the impact of combined therapy versus monotherapy on the course of this disease. SUBJECTS AND METHODS: The investigation enrolled 62 patients with non-acidic GERD. The follow-up period was 6 weeks. The patients were divided into 2 groups: 1) weakly acidic gastroesophageal refluxes (GER); 2) weakly alkaline GER. Then each group was distributed, thus making up 4 groups: 1) 19 patients with weakly acidic GER who received monotherapy with rabeprazole 20 mg/day; 2) 21 patients with weakly acidic GER had combined therapy with rabeprazole 20 mg and itopride; 3) 8 patients with weakly alkaline GER who received ursodeoxycholic acid (UDCA) monotherapy; and 4) 14 patients with weakly alkaline GER who had combined therapy with UDCA and itopride, The clinical symptoms of the disease, the endoscopic pattern of the upper gastrointestinal tract (GIT) mucosa, histological changes in the esophageal and gastric mucosa, and the results of 24-hour impedance pH monitoring were assessed over time...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28459037/levosulpiride-and-serum-prolactin-levels
#17
Mohammad Shafi Kuchay, Ambrish Mithal
Levosulpiride is the levorotatory enantiomer of sulpiride used in dyspeptic syndromes of various etiologies. The prokinetic effect of levosulpiride is mediated through the blockade of enteric inhibitory dopaminergic type 2 (D2) receptors. The antagonism of central D2 receptors leads to both therapeutic (e.g. antiemetic effect due to D2 receptor blockade in the chemoreceptor trigger zone) and adverse (including hyperprolactinemia) effects. Dopamine is the main endogenous inhibitor of prolactin synthesis and secretion in the anterior pituitary...
March 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28449422/the-effect-of-anti-reflux-therapy-on-patients-diagnosed-with-minor-disorders-of-peristalsis-in-high-resolution-manometry
#18
Joonho Jeong, Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Youn Jung Choi, Jun Yeob Lee, Young Dal Lee
Background/Aims: Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders. Methods: Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28431454/da-9701-improves-colonic-transit-time-and-symptoms-in-patients-with-functional-constipation-a-prospective-study
#19
Su Young Kim, Hyun Sun Woo, Sung Han Choi, Dong Kyun Park, Kwang An Kwon, Jun-Won Chung, Yoon Jae Kim, Jung Ho Kim, Su Ji Kim, Kyoung Oh Kim
BACKGROUND AND AIM: DA-9701, a newly developed prokinetic agent formulated with Pharbitis Semen and Corydalis Tuber, has been shown to effectively treat functional dyspepsia. Recently, it has also been suspected to improve gastrointestinal motor function. The aims of this study were to assess the effect of DA-9701 on colonic transit time (CTT) and symptoms of functional constipation. METHODS: We prospectively enrolled 33 patients with functional constipation based on the Rome III criteria...
April 21, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28424994/modulation-of-gastrointestinal-motility-beyond-metoclopramide-and-domperidone-pharmacological-and-clinical-evidence-for-phytotherapy-in-functional-gastrointestinal-disorders
#20
Ahmed Madisch, Bettina R Vinson, Heba Abdel-Aziz, Olaf Kelber, Karen Nieber, Karin Kraft, Martin Storr
The prokinetic cisapride, an important therapeutic option in functional gastrointestinal (GI) disorders, was withdrawn from the market 15 years ago due to rare severe side effects. Likewise in 2014, the use of metoclopramide (MCP) and domperidone in functional GI disorders (FGID) was restricted, consequently leaving a therapeutic gap in clinical practice. A systematic review revealed that the herbal medicinal product (HMP) STW 5 presents a therapeutic option equivalent to MCP and cisapride. STW 5 is the only HMP for which efficacy has been shown in randomized controlled clinical trials (RCTs) in functional dyspepsia and irritable bowel syndrome, based on its multitarget effect on numerous etiological factors...
May 2017: Wiener Medizinische Wochenschrift
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