Assuntos
Gastroenterologia/educação , Medicina Psicossomática/educação , Adulto , Atitude Frente a Saúde , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/psicologia , Úlcera Duodenal/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Personalidade , Transtornos Psicofisiológicos/diagnóstico , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapia , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/psicologia , Úlcera Gástrica/terapiaRESUMO
Altogether 850 patients suffering from chronic constipation were examined. Of these, 80% only showed functional changes in the intestine, 5% lost the defecation reflex, and 15% manifested inflammation-induced lesions in the intestine. 80% of the patients demonstrated symptoms of dysbacteriosis. Multimodality treatment appeared to produce an appreciable effect in the majority of the patients. As a result many of the patients gave up laxatives.
Assuntos
Constipação Intestinal/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Terapia Combinada/métodos , Constipação Intestinal/etiologia , Constipação Intestinal/terapia , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The paper is concerned with the results of clinical assessment of a new peptide drug dalargin in therapy of duodenal peptic ulcer. Assessment of the efficacy of dalargin was compared to that of tagamet and placebo using double "blind" control. A total of 180 males with exacerbation of duodenal ulcer were examined, of them 90 received dalargin only, 70 received tagamet and 20 persons participated in an experiment based on a method of double "blind" control. An average period of duodenal ulcer healing in the patients on dalargin therapy was 21.4 +/- 1.2 days, and by the 28th day complete cicatrization was observed in 87.5% of the patients. In tagamet therapy an average period of cicatrization was 23.7 +/- 1.8 days, by the 28th day ulcer healing was observed in 87.3%. With placebo ulcer healing by the 4th week was observed in 30% of the examinees, in dalargin therapy in 80%. A conclusion was made of high efficacy of dalargin for therapy of peptic ulcer.
Assuntos
Úlcera Duodenal/tratamento farmacológico , Leucina Encefalina-2-Alanina/análogos & derivados , Encefalina Leucina/análogos & derivados , Adolescente , Adulto , Cimetidina/uso terapêutico , Ensaios Clínicos como Assunto , Método Duplo-Cego , Encefalina Leucina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The distribution of gastrin-, gamma-endorphin and somatostatin-producing cells in antral and duodenal mucosa was studied in biopsies from 26 patients with duodenal ulcer and from 13 controls by the immunohistochemical (PAP) method. The number of antral somatostatin-producing cells after dalargin treatment was significantly higher in comparison with controls and patients treated with antacids plus atropine. These changes may be connected with the antiulcer activity of dalargin, a new opioid peptide drug.
Assuntos
Sistema Cromafim/metabolismo , Úlcera Duodenal/patologia , Leucina Encefalina-2-Alanina/análogos & derivados , Encefalina Leucina/análogos & derivados , Células Enterocromafins/metabolismo , Hormônios Gastrointestinais/metabolismo , Adulto , Úlcera Duodenal/tratamento farmacológico , Duodeno/patologia , Endorfinas/metabolismo , Encefalina Leucina/uso terapêutico , Gastrinas/metabolismo , Humanos , Masculino , Antro Pilórico/patologia , Somatostatina/metabolismo , gama-EndorfinaRESUMO
The influence of different doses (0.01, 0.1, 1.0, 10.0, 100.0, 250.0, 1,000.0, 2,500.0 gamma/kg body weight) of testosterone, dihydrotestosterone, 5 alpha-androstane-3 alpha, 17 beta-diol, 5 alpha-androstane-3 beta, 17 beta-diall, 4-androsterone-3,17-dione, estradiol and progesterone on the formation of cysteamine-induced duodenal ulcer was studied in mature male rats. It has been shown that all the steroids, but for progesterone, bring down the ulcer index after six days of i/p administration, the effect depending on the nature and dose of a steroid. Estradiol and 4-androstene-3,17-dione proved to be the most effective in the given dose range. The results do not only confirm the role of androgens and estradiol in the pathogenesis of duodenal ulcer, but also indicate the participation of their precursors and metabolites in the ulcer induction. The prospects of using steroids in the treatment of ulcer are discussed.
Assuntos
Úlcera Duodenal/induzido quimicamente , Estradiol/farmacologia , Progesterona/farmacologia , Testosterona/farmacologia , Androstano-3,17-diol/metabolismo , Androstano-3,17-diol/farmacologia , Animais , Cisteamina/toxicidade , Di-Hidrotestosterona/metabolismo , Di-Hidrotestosterona/farmacologia , Relação Dose-Resposta a Droga , Úlcera Duodenal/metabolismo , Estradiol/metabolismo , Mucosa Intestinal/metabolismo , Masculino , Progesterona/metabolismo , Ratos , Testosterona/metabolismoAssuntos
Antiulcerosos/uso terapêutico , Leucina Encefalina-2-Alanina/análogos & derivados , Encefalina Leucina/análogos & derivados , Úlcera Péptica/tratamento farmacológico , Adolescente , Adulto , Cimetidina/uso terapêutico , Ensaios Clínicos como Assunto , Encefalina Leucina/efeitos adversos , Encefalina Leucina/uso terapêutico , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
The authors compared the efficacy of the blockers of H2-histamine receptors with the conventional multimodality treatment in patients with peptic ulcer of the duodenum and explored the effect of cimetidine on the secretory and motor functions of the stomach and on the endocrine status of the patients. It was established that cimetidine made the healing of duodenal ulcers more rapid as compared with the use of the multimodality therapy. It was also found that the drug efficacy was mainly related to the suppression of hydrochloric acid secretion in the stomach and to the recovery of motor activity of the stomach and duodenum. It is demonstrated that cimetidine has a broad-range action on the endocrine system, which should be taken into consideration in administering cimetidine.
Assuntos
Cimetidina/uso terapêutico , Úlcera Duodenal/tratamento farmacológico , Adolescente , Adulto , Ensaios Clínicos como Assunto , Úlcera Duodenal/fisiopatologia , Ácido Gástrico/metabolismo , Mucosa Gástrica/metabolismo , Motilidade Gastrointestinal , Hormônios/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Propantelina/uso terapêuticoAssuntos
Células APUD/efeitos dos fármacos , Antiulcerosos/uso terapêutico , Sistema Digestório/efeitos dos fármacos , Úlcera Duodenal/tratamento farmacológico , Leucina Encefalina-2-Alanina/análogos & derivados , Encefalina Leucina/análogos & derivados , Células APUD/patologia , Biópsia , Sistema Digestório/patologia , Avaliação de Medicamentos , Úlcera Duodenal/patologia , Encefalina Leucina/uso terapêutico , HumanosRESUMO
Possibilities of application of immunomorphologic methods to gastrointestinal apud cells study were evaluated. These are: immunofluorescent, immunoenzyme, immune-peroxidase, peroxidase-antiperoxidase, avidinbiotin. Causes of immunologic and non-immunologic non-specific background staining and the means of its elimination are discussed, as well as problems of fixation and embedding of the material.
Assuntos
Células APUD/citologia , Sistema Digestório/citologia , Células APUD/imunologia , Animais , Avidina , Biotina , Técnicas Citológicas , Sistema Digestório/imunologia , Células Epiteliais , Epitopos/análise , Fluoresceínas , Histocitoquímica , Humanos , Imunização , Imunoglobulina G/análise , Técnicas Imunológicas , Coelhos , Coloração e Rotulagem/métodosRESUMO
Stress caused by acute cysteamine duodenal ulcer was induced in Wistar male rats. All the endogenous opioides under study were involved in the stress-reaction mechanism. Protective dalargin (synthetic enkephalin analogue) administration revealed a tendency towards normalization of endorphin, L-enkephalin and ACTH blood levels.
Assuntos
Hormônio Adrenocorticotrópico/sangue , Corticosterona/sangue , Endorfinas/sangue , Leucina Encefalina-2-Alanina/análogos & derivados , Encefalina Leucina/análogos & derivados , Encefalina Leucina/sangue , Estresse Fisiológico/tratamento farmacológico , Doença Aguda , Animais , Líquido Ascítico , Avaliação Pré-Clínica de Medicamentos , Encefalina Leucina/uso terapêutico , Masculino , Peritonite/sangue , Peritonite/tratamento farmacológico , Peritonite/etiologia , Ratos , Ratos Endogâmicos , Estresse Fisiológico/sangue , Estresse Fisiológico/etiologia , Fatores de Tempo , Toxinas Biológicas/toxicidadeRESUMO
The authors describe the results of studying basal gastrin secretion in patients with peptic ulcer of the duodenum at different phases of disease treated in 3 stages. It was revealed that basal secretion of gastrin experienced substantial changes in the course of transition from the phase of exacerbation to the phase of disease remission. It was noted that the onset of the clinico-endoscopic remission of peptic ulcer did not correlate in all the cases with normalization of basal gastrin level. Patients who did not show normalization of basal gastrin level during treatment were more prone to the development of repeated exacerbations. Based on the data obtained the authors determined the prognostic importance of radioimmunoassay of gastrin basal concentration over time. The increment of gastrin concentration by more than 35 pg/ml of the level seen during peptic ulcer exacerbation is a prognostically unfavourable sign, for the probability of relapses rises up to 79% during a year.
Assuntos
Úlcera Duodenal/sangue , Gastrinas/sangue , Adulto , Idoso , Doença Crônica , Úlcera Duodenal/terapia , Duodenoscopia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Radioimunoensaio , Recidiva , Fatores de TempoRESUMO
Interrelationship was studied between the influence of cysteamine on pain threshold and ulcerogenic effect on the duodenum. Cysteamine (350 mg/kg) induced analgesia in mice which was prevented by naloxone (1.5 mg/kg). In rats, cysteamine produced duodenal ulcers with concomitant analgesia. The intensity of ulceration was higher in animals with lower basal pain threshold. The correlation between central and peripheral effects of endogenous opioids in the development of experimental duodenal ulcers is discussed.
Assuntos
Analgésicos , Cisteamina/farmacologia , Úlcera Duodenal/induzido quimicamente , Animais , Cisteamina/antagonistas & inibidores , Cisteamina/toxicidade , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Naloxona/farmacologia , Dor/tratamento farmacológico , Dor/fisiopatologia , Ratos , Ratos Endogâmicos , Limiar Sensorial/efeitos dos fármacos , Fatores de TempoAssuntos
Proteínas do Tecido Nervoso/uso terapêutico , Receptores Opioides/efeitos dos fármacos , Barreira Hematoencefálica , Doença Crônica , Esquema de Medicação , Gastrinas/metabolismo , Humanos , Proteínas do Tecido Nervoso/administração & dosagem , Proteínas do Tecido Nervoso/sangue , Úlcera Péptica/tratamento farmacológico , Úlcera Péptica/fisiopatologia , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/fisiopatologiaRESUMO
Experiments on rats were made to study antiulcerous activity of the majority of endogenous opioid-like peptides and 22 synthetic analogs. Duodenal ulcers were induced in animals by cysteamine hydrochloride. A hexapeptide called dalargin demonstrated the maximal antiulcerous activity in experimental duodenal ulcer. The drug dose applied was 10-15 micrograms/kg. The drug action was found to be mediated via opiate receptors. The drug did not cause the development of addiction or physical dependence. Dalargin was studied in 45 male patients with exacerbation of duodenal ulcer. The mean period of healing amounted to 21.8 days. The use of dalargin in a dose of 2 mg a day intramuscularly produced no side effects or changes in blood characteristics. The mechanisms of dalargin action are discussed from the viewpoint of the general principles of peptide pharmacology.
Assuntos
Úlcera Duodenal/tratamento farmacológico , Encefalina Leucina/uso terapêutico , Adulto , Animais , Ensaios Clínicos como Assunto , Avaliação Pré-Clínica de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Ratos , Ratos EndogâmicosRESUMO
The effects of modern antiulcerous drugs and local action on the gastric mucosa by endoscopy were studied and compared. The endocrine characteristics of the blood serum were analysed in patients with duodenal ulcer after acute and prolonged use of antiulcerous drugs. The treatment with high doses of phosphalugel and cimetidine was shown to compare very favourably with conventional therapy. Duogastron was found to have a low antiulcerous activity. Cimetidine, duogastron and reglan exerted a marked effect on the endocrine system, which should be taken into consideration on prolonged drug use. Local action on the gastric mucosa by means of endoscopy appeared to be effective in patients resistant to drug therapy.
Assuntos
Antiulcerosos/administração & dosagem , Úlcera Duodenal/tratamento farmacológico , Administração Tópica , Adolescente , Adulto , Relação Dose-Resposta a Droga , Avaliação de Medicamentos , Quimioterapia Combinada , Úlcera Duodenal/fisiopatologia , Duodenoscopia , Hormônios/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Immunohistochemistry was used to study the changes in the number of G cells in the antral part of the stomach of rats (40 animals) with cystamine-induced duodenal ulcer treated with beta-endorphine. In the stomach of rats with cystamine-induced ulcer the number of G cells was discovered to be significantly increased, which was removed by an opioid peptide. Naloxone did not block the action of beta-endorphine. Thus, beta-endorphine changes the number of G cells, the drug action being not associated with opiate receptors.
Assuntos
Úlcera Duodenal/tratamento farmacológico , Endorfinas/uso terapêutico , Gastrinas/metabolismo , Estômago/patologia , Animais , Cisteamina , Úlcera Duodenal/induzido quimicamente , Mucosa Gástrica/metabolismo , Masculino , Ratos , Ratos Endogâmicos , beta-EndorfinaRESUMO
Immunohistochemical staining with the use of peroxidase-antiperoxidase was applied to study cells producing gamma- and alpha-endorphines in the gastric antral mucosa in duodenal ulcer. The cells producing gamma-endorphines were discovered to be mainly located in the epithelium of the cervical and upper third of the pyloric glands and to be alike G-cells producing gastrin. The cells producing alpha-endorphine were found both in the epithelium of the upper third of the gastric pyloric glands and in the gastric mucosa lamina proper. In peptic ulcer, there was an almost two-fold increase in the amount of gamma-endorphine-producing cells and diminution of epithelial endocrine cells producing alpha-endorphine.
Assuntos
Úlcera Duodenal/patologia , Endorfinas/metabolismo , Antro Pilórico/patologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Antro Pilórico/metabolismo , alfa-Endorfina , gama-EndorfinaRESUMO
Morphometry was used to study the action of an enkephalin analog and beta-endorphine on the duodenal mucosa in rats with an experimental ulcer induced by cysteamine. Enkephalin produced a more powerful protective action than endorphine. The antiulcerous action was manifested in the diminution of dystrophic changes, redistribution of inflamed cells with an increase in the lymphocyte and monocyte counts, and in the reduction of the number of tissue macrophages and histocytes. Administration of opioids provoked a particularly marked increase in the eosinophil count in the duodenal mucosa. All these effects were abolished by naloxone. It is concluded that the tissue effects of opioids are mediated by specific opiate receptors.