RESUMEN
This study investigated the clinical relevance of acute pancreatitis in allogeneic hemopoietic stem cell (bone marrow or peripheral blood) transplants (BMT). We studied 26 patients undergoing BMT. The preparative regimen was busulfan and cyclophosphamide in 17 patients and total body irradiation and cyclophosphamide in 9 patients. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and short-term methotrexate in all 26 patients. The pancreas was studied using amylase and lipase serum levels, abdominal contrast-enhanced tomography, and/or ultrasound. Clinical and laboratory signs of acute pancreatitis were found in two patients with acute hepatointestinal GVHD, and in one patient with acute hepatic GVHD and cytomegalovirus infection. This patient died of multiorgan failure, with interstitial acute pancreatitis at autopsy; the other two patients recovered with general supportive care and GVHD therapy. We suggest that in the patients with complications after BMT, particularly acute hepatic/hepatointestinal GVHD, and cytomegalovirus infection, the possibility of acute pancreatitis should be considered.
Asunto(s)
Trasplante de Médula Ósea/efectos adversos , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Pancreatitis/etiología , Acondicionamiento Pretrasplante/efectos adversos , Enfermedad Aguda , Adulto , Amilasas/sangre , Trasplante de Médula Ósea/métodos , Pruebas Enzimáticas Clínicas , Femenino , Enfermedad Injerto contra Huésped/epidemiología , Enfermedad Injerto contra Huésped/etiología , Enfermedad Injerto contra Huésped/prevención & control , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Incidencia , Lipasa/sangre , Masculino , Persona de Mediana Edad , Páncreas/diagnóstico por imagen , Pancreatitis/diagnóstico , Pancreatitis/epidemiología , Radiografía , Factores de Tiempo , Acondicionamiento Pretrasplante/métodos , Trasplante Homólogo , UltrasonografíaRESUMEN
In a double blind crossover comparison with placebo, the effects of cisapride (10 mg tid for two weeks), a non-antidopaminergic gastrointestinal prokinetic drug, on gastric emptying times and on symptoms were evaluated in 12 patients with chronic idiopathic dyspepsia and gastroparesis. Gastric emptying was studied by a radioisotopic gamma camera technique. The test meal was labelled in the solid component (99mTc-sulphur colloid infiltrated chicken liver). Nine symptoms (nausea, belching, regurgitations, vomiting, postprandial drowsiness, early satiety, epigastric pain or burning, heartburn) were graded weekly on a questionnaire. Cisapride was significantly more effective than placebo in shortening the t1/2 of gastric emptying (p2 = 0.04), but no significant difference was observed between the two treatments with regard to the improvement of total symptom score (p2 = 0.09). No side effects were reported during the study.
Asunto(s)
Dispepsia/tratamiento farmacológico , Vaciamiento Gástrico/efectos de los fármacos , Piperidinas/uso terapéutico , Gastropatías/tratamiento farmacológico , Adulto , Cisaprida , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Parálisis/tratamiento farmacológico , Parálisis/fisiopatología , Gastropatías/fisiopatologíaRESUMEN
The influence of Thyropramide, a recently developed spasmolytic on the gastric emptying times of a solid meal was assessed in 10 healthy subjects aged 23-54. Thyropramide (300 mg per diem for 3 days per os) does not significantly modify gastric emptying time compared to the placebo though a slight average increase in T 1/2 was noted. No side effects were noted during the study. Thyropramide therefore appears to have a spasmolytic effect on the large intestine without in any way influence the stomach either proximally or distally.
Asunto(s)
Vaciamiento Gástrico/efectos de los fármacos , Parasimpatolíticos/farmacología , Tirosina/análogos & derivados , Adulto , Femenino , Humanos , Intestino Grueso/efectos de los fármacos , Masculino , Persona de Mediana Edad , Parasimpatolíticos/administración & dosificación , Tirosina/administración & dosificación , Tirosina/farmacologíaAsunto(s)
Dentadura Completa , Vaciamiento Gástrico , Masticación , Anciano , Femenino , Humanos , Masculino , Estómago/fisiología , Factores de TiempoRESUMEN
This paper reviews investigations on the endocrine effects of two H2-receptor antagonists, cimetidine and ranitidine. Cimetidine has hyperprolactinaemic properties and interferes with the peripheral activity of the sexual hormone (DHT) and probably with the pituitary LH secretion. A possible effect on TSH and thyroid hormone secretion or peripheral metabolism is suggested. Ranitidine seems to have no central or peripheral effects (after both acute and chronic administration) on sexual hormones. High doses (300 mg i.v. bolus) of the drug induce a significant increase in prolactin basal levels, whereas no effects follow oral administration. The effects on PRL are sex-related and less marked than those obtained with cimetidine. The chronic administration of this drug does not affect basal or TRH-stimulated PRL levels. No effects were apparent on TSH serum levels after either oral or i.v. acute administration, whereas lower basal and TRH-stimulated T4 values were registered after chronic treatment. On the basis of these results, a possible interference of ranitidine on iodothyronine metabolism can be suggested.