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Diabetic gastroparesis

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https://www.readbyqxmd.com/read/29782470/characterizing-abdominal-pain-in-patients-with-gastroparesis-into-neuropathic-and-nociceptive-components
#1
Asad Jehangir, Rany T Abdallah, Henry P Parkman
INTRODUCTION: The cause of abdominal pain (AP) in gastroparesis (Gp) is often not known; hence, its treatment can be challenging. Preoccupation with or increased attention (hypervigilance) to pain is associated with perceived pain severity and psychosocial disability. The aims of this study were to (1) characterize AP in Gp patients into neuropathic and nociceptive pain components; (2) assess these patients for hypervigilance to pain. MATERIALS AND METHODS: Gp patients with AP as an important symptom, seen from June 2017 to November 2017 were given validated questionnaires to characterize their AP...
May 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29748143/the-investigation-and-treatment-of-diabetic-gastroparesis
#2
REVIEW
Mohit Kumar, Adam Chapman, Saad Javed, Uazman Alam, Rayaz A Malik, Shazli Azmi
PURPOSE: This review provides an update on the investigations and treatment options for gastroparesis. METHODS: A comprehensive literature search of Medline, PubMed, Embase and OVID was conducted which included all systematic reviews and research articles that focused on the diagnosis, investigations and management diabetic gastroparesis. FINDINGS: Dietary modifications and pharmacologic treatment with prokinetics to increase gastric motility form the mainstay of treatment...
May 7, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29745434/efficacy-of-needleless-transcutaneous-electroacupuncture-in-synchronization-with-breathing-for-symptomatic-idiopathic-gastroparesis-a-blinded-and-controlled-acute-treatment-trial
#3
G Song, Y Sun, M Bashashati, A Quezada, S Sigaroodi, I Sarosiek, J D Z Chen, R W McCallum
BACKGROUND: Needleless transcutaneous electroacupuncture (TEA) improves nausea and myoelectrical activity in diabetic gastroparesis (GP). Synchronized TEA (STEA), which combines synchronized breathing with TEA, is more potent than TEA in enhancing vagal activity in healthy subjects. AIMS: To investigate whether STEA improves symptoms, electrogastrogram (EGG) and vagal activity in idiopathic gastroparesis (IGP). METHODS: Eighteen IGP subjects underwent 2 randomized visits (sham at non-acupoints or real STEA at acupoints) consisted of a 30-minute baseline, an Ensure challenge to provoke nausea, followed by 60-minute treatment with sham or real STEA, and 15-minute observation period...
May 10, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29722126/reproducibility-of-gastric-emptying-assessed-with-scintigraphy-in-patients-with-upper-gi-symptoms
#4
A Desai, M O'Connor, B Neja, K Delaney, M Camilleri, A R Zinsmeister, A E Bharucha
BACKGROUND: The reproducibility of gastric emptying (GE) measured with scintigraphy in patients is poorly understood. Our aims were to assess the intra and inter-individual reproducibility of these parameters in patients with upper gastrointestinal symptoms. METHODS: Sixty patients (21 diabetics, 39 non-diabetics) with upper gastrointestinal symptoms underwent scintigraphic-assessment of GE of a solid meal (296 kcal, 30% fat) over 4 hours on two occasions at an average interval of 15 days...
May 2, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29709494/pyloric-sphincter-characteristics-using-endoflip-%C3%A2-in-gastroparesis
#5
M Saadi, D Yu, Z Malik, H P Parkman, R Schey
INTRODUCTION AND AIMS: Pyloric sphincter abnormalities may be detected in gastroparesis. Botulinum toxin A (BoNT/A) injection into the pylorus has been used to treat gastroparesis with varying results. The aim of the present article was to assess whether pyloric sphincter characteristics using the endoscopic functional lumen imaging probe (EndoFLIP® ) with impedance planimetry in patients with gastroparesis correlated with symptoms, gastric emptying, and therapeutic response to pyloric sphincter BoNT/A injection...
April 27, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29652893/glucose-sensor-augmented-continuous-subcutaneous-insulin-infusion-in-patients-with-diabetic-gastroparesis-an-open-label-pilot-prospective-study
#6
Jorge Calles-Escandón, Kenneth L Koch, William L Hasler, Mark L Van Natta, Pankaj J Pasricha, James Tonascia, Henry P Parkman, Frank Hamilton, William H Herman, Marina Basina, Bruce Buckingham, Karen Earle, Kjersti Kirkeby, Kristen Hairston, Tamis Bright, Amy E Rothberg, Andrew T Kraftson, Elias S Siraj, Angela Subauste, Linda A Lee, Thomas L Abell, Richard W McCallum, Irene Sarosiek, Linda Nguyen, Ronnie Fass, William J Snape, Ivana A Vaughn, Laura A Miriel, Gianrico Farrugia
Erratic blood glucose levels can be a cause and consequence of delayed gastric emptying in patients with diabetes. It is unknown if better glycemic control increases risks of hypoglycemia or improves hemoglobin A1c levels and gastrointestinal symptoms in diabetic gastroparesis. This study investigated the safety and potential efficacy of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in poorly controlled diabetes with gastroparesis. Forty-five type 1 or 2 patients with diabetes and gastroparesis and hemoglobin A1c >8% from the NIDDK Gastroparesis Consortium enrolled in a 24 week open-label pilot prospective study of CSII plus CGM...
2018: PloS One
https://www.readbyqxmd.com/read/29599809/electroacupuncture-at-st36-increases-bone-marrow-derived-interstitial-cells-of-cajal-via-the-sdf-1-cxcr4-and-mscf-kit-etv1-pathways-in-the-stomach-of-diabetic-mice
#7
Jiao Zhao, Jing An, Shi Liu
Background: The loss of interstitial cells of Cajal (ICC) is observed in diabetic gastroparesis. Electroacupuncture (EA) maintains ICC networks, but the effects and mechanisms of EA on ICC of bone marrow derivation in the stomach have not been investigated. Methods: C57BL/6 mice were randomized into six groups: control, diabetic (DM), bone marrow transplantation (BMT) + DM, BMT + DM + sham EA (SEA), BMT + DM + low-frequency EA (LEA), and BMT + DM + high-frequency (HEA)...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29560632/-effect-of-different-stimulating-strength-of-electroacupuncture-on-gastrointestinal-motility-and-rhoa-rock-signaling-in-gastric-antral-smooth-muscle-in-diabetic-gastroparesis-rats
#8
Xue-Fen Wu, Xiao-Li Chen, Xue-Na Zheng, Xin Guo, Zhi-Qiang Xie, Li Liu, Xin-Ran Wei, Zeng-Hui Yue
OBJECTIVE: To observe the effect of different strength of electroacupuncture (EA) stimulation on gastrointestinal motility and Ras homolog gene family member (RhoA)/Rho associated coiled-coil forming protein kinase (ROCK) signaling in diabetic gastroparesis (DGP) rats, so as to reveal the underlying mechanisms of EA for improving DGP. METHODS: Sixty SD rats were randomly and equally divided into blank control, DGP model, weak EA, medium EA, and strong EA groups ( n =12 rats in each)...
March 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29559406/postoperative-period
#9
(no author information available yet)
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29533548/gastrointestinal-complications-in-patients-with-diabetes-mellitus
#10
REVIEW
Agnieszka E Zawada, Małgorzata Moszak, Dorota Skrzypczak, Marian Grzymisławski
Diabetes mellitus is a systemic disease which affects patients of various age. Hyperglycemia induces damage of vascular endothelium, development of chronic inflammation, organic and functional lesions in several systems and organs. The principal gastroenterological complaints linked to the manifestation of the disease include abdominal pain, diarrhea, nausea, flatulence, and vomiting. However, complications in the alimentary system may manifest exclusively by difficulties in reaching normoglycemia and numerous persistent episodes of hypoglycemia...
March 13, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29501441/change-in-populations-of-macrophages-promotes-development-of-delayed-gastric-emptying-in-mice
#11
Gianluca Cipriani, Simon J Gibbons, Katie E Miller, Daniel S Yang, Matthew L Terhaar, Seth T Eisenman, Tamas Ördög, David R Linden, Gabriela B Gajdos, Joseph H Szurszewski, Gianrico Farrugia
BACKGROUND & AIMS: Muscularis propria macrophages lie close to cells that regulate gastrointestinal motor function, including interstitial cells of Cajal (ICC) and myenteric neurons. In animal models of diabetic gastroparesis, development of delayed gastric emptying has been associated with loss of macrophages that express cytoprotective markers and reduced networks of ICC. Mice with long-term diabetes and normal gastric emptying have macrophages that express anti-inflammatory markers and have normal gastric ICC...
March 6, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29487566/islet-cell-associated-autoantibodies-and-c-peptide-levels-in-patients-with-diabetes-and-symptoms-of-gastroparesis
#12
Elias S Siraj, Carol Homko, Laura A Wilson, Patrick May, Ajay D Rao, Jorge Calles, Gianrico Farrugia, William L Hasler, Kenneth L Koch, Linda Nguyen, William J Snape, Thomas L Abell, Irene Sarosiek, Richard W McCallum, Pankaj J Pasricha, John Clarke, James Tonascia, Frank Hamilton, Henry P Parkman
Introduction: Individuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimmunity while C-peptide level is used to assess beta-cell function. Patients with type 2 diabetes mellitus (T2DM), who are GADA positive, are labeled latent autoimmune diabetes in adults (LADA)...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29468376/gastric-per-oral-endoscopic-myotomy-g-poem-for-the-treatment-of-refractory-gastroparesis-early-experience
#13
Zubair Malik, Rahul Kataria, Rani Modayil, Adam C Ehrlich, Ron Schey, Henry P Parkman, Stavros N Stavropoulos
BACKGROUND: Gastric per oral endoscopic myotomy (G-POEM) of the pylorus is a technique that is recently being used to treat gastroparesis. Our aim was to report our experience in performing G-POEM for refractory gastroparesis of different etiologies and determine symptom improvement. METHODS: Thirteen patients undergoing G-POEM are reported. Pre- and post-procedure gastric emptying study (GES) and PAGI-SYM for symptom severity were obtained. Patients underwent G-POEM by creating a submucosal tunnel starting in the greater curvature of the distal antrum and extending it to the beginning of the duodenal bulb, followed by a full thickness pyloromyotomy...
February 22, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29441814/analysis-of-gastric-myoelectrical-activity-from-the-electrogastrogram-signals-based-on-wavelet-transform-and-line-length-feature
#14
Abdullah Al Kafee, Aydin Akan
Electrogastrogram is used for the abdominal surface measurement of the gastric electrical activity of the human stomach. The electrogastrogram technique has significant value as a clinical tool because careful electrogastrogram signal recordings and analyses play a major role in determining the propagation and coordination of gastric myoelectric abnormalities. The aim of this article is to evaluate electrogastrogram features calculated by line length features based on the discrete wavelet transform method to differentiate healthy control subjects from patients with functional dyspepsia and diabetic gastroparesis...
April 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29429379/formulation-development-and-evaluation-of-nifedipine-as-pylorospasm-inhibitor
#15
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...
July 2018: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/29360501/emerging-role-of-carbon-monoxide-in-regulation-of-cellular-pathways-and-in-the-maintenance-of-gastric-mucosal-integrity
#16
REVIEW
Katarzyna Magierowska, Tomasz Brzozowski, Marcin Magierowski
Heme oxygenase (HO) catalyzes the degradation of toxic free heme to the equimolar amounts of biliverdin, Fe2+ and concurrently releases of carbon monoxide (CO). CO is nowadays increasingly recognized as an important signaling molecule throughout the body that is involved in many physiological processes and shows multidirectional biological activity. Recent evidence indicates that CO exhibits the anti-inflammatory, anti-proliferative, anti-apoptotic, anti-aggregatory and vasodilatory properties. The cellular mechanisms underlying the activity of CO involve stimulation of cGMP-dependent signaling pathway and large conductance calcium activated K+ channels, the activation of mitogen-activated protein kinases and the nuclear factor k-light chain-enhancer of activated B cells transcription factor pathway...
March 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29318852/-effects-of-electroacupuncture-on-ultrastructure-of-interstitial-cells-of-cajal-and-stem-cell-factor-kit-signal-pathway-of-gastric-antrum-in-diabetic-gastroparesis-rats
#17
Cheng-Cheng Zhang, Ya-Ping Lin, Yan Peng, Zeng-Hui Yue, Hai-Jiao Chen, Jian-Wen Yang, Wei-Wei Liu, Li Liu
OBJECTIVE: To observe the effects of electroacupuncture (EA) on gastrointestinal motility and the ultrastructure of interstitial cells of Cajal (ICC) and the expressions of c-kit receptor protein and stem cell factor (SCF) mRNA in diabetic gastroparesis (DGP) rats, so as to explore its mechanism. METHODS: Fifty SD rats were randomly divided into normal, model, acupoint, non-acupoint and metoclopramide groups (n=10 rats/group). DGP model was established by intraperitoneal injection of streptozotocin (STZ, 2%), and raised with high-sugar high-fat diet irregularly...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29317209/lncrna-malat1-is-up-regulated-in-diabetic-gastroparesis-and-involved-in-high-glucose-induced-cellular-processes-in-human-gastric-smooth-muscle-cells
#18
Yaoyao Gong, Ying Zhu, Boqian Zhu, Xinmin Si, Ding Heng, Yurong Tang, Xiaomeng Sun, Lin Lin
Recent years, widespread long non-coding RNAs (lncRNAs) were identified and known as regulator of gene expression. Diabetic gastroparesis (DGP) is one of the most common chronic complications of diabetes mellitus. There was no research reported the role of lncRNAs in DGP. In this study, we firstly established a rat model of DGP by STZ injection. Then, we detected the expression of MALAT1 and found that expression of MALAT1 was up-regulated in rat model of DGP, comparing to the control group (P < .01)...
February 5, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29222714/domperidone-prolongs-oral-to-duodenal-transit-time-in-video-capsule-endoscopy
#19
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...
April 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29205691/intravenous-immunoglobulin-in-drug-and-device-refractory-patients-with-the-symptoms-of-gastroparesis-an-open-label-study
#20
M Ashat, A Lewis, H Liaquat, A Stocker, L McElmurray, V Vedanarayanan, K Soota, T Howell, A Kedar, J Obert, T L Abell
BACKGROUND: Gastroparesis is a complex clinical entity; many aspects of which remain unknown. Although most patients have idiopathic, diabetic, or postsurgical gastroparesis, many are thought to have measurable neuromuscular abnormalities. Immunotherapy has recently been utilized to treat suspected autoimmune gastrointestinal dysmotility. METHODS: Fourteen patients with symptoms of gastroparesis (Gp) who were refractory to drug/device were selected from 443 Gp patients from 2013 to 2015 who were treated at the University of Louisville motility center...
March 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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