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1.
Rev. bras. plantas med ; 18(2): 473-479, 2016. tab
Article in English | LILACS | ID: lil-787938

ABSTRACT

ABSTRACT ndustrial chemicals that control pests in stored seed can cause damage to health by residual effects remaining in the grains. Studies of products with potential insecticide and repellent properties are required to decrease post-harvest losses. Thus, the aim of this study was to evaluate the quality and efficiency of seed treatment in beans stored under the following treatments: dried leaves and crushed laurel (Laurus nobilis L.), rosemary (Rosmarinus officinalis L.) and basil (Ocimum basilicum L.), cinnamon powder (Cinnamomum zeylanicum Breyn) and ground cloves (Syzygium aromaticum L.) over eight months. An untreated control and a treatment with diatomaceous earth were used to compare the results. At the beginning and at 30 days, percentages of normal and abnormal seedlings as well as seeds that did not germinate, mass of onehundred seeds, water content and infested seeds were analyzed. At 210 and 240 days, free choice arena and repellency testswere conducted. Treatments did not affect germination, mass of 100 seeds or water content; however, all plants tested showed a repellent effect on the bean weevil.


RESUMO Produtos químicos industriais que controlam pragas de sementes e grãos armazenados podem causar danos à saúde pelo efeito residual que proporcionam. Assim, são necessários estudos de produtos que apresentem repelência e potencial inseticida e reduzam perdas pós-colheita sem causar danos à saúde. Neste contexto, o objetivo deste trabalho foi avaliar a qualidade e eficiência do tratamento com plantas aromáticas: folhas desidratadas e moídas de louro (Laurus nobilis), alecrim (Rosmarinus officinalis) e manjericão (Ocimum basilicum L.), canela em pó (Cinnamomum zeylanicum Breyn) e cravo moído (Syzygium aromaticum L.), em sementes de feijão carioca armazenadas durante oito meses. Uma testemunha sem tratamento e outra com terra de diatomáceas foram utilizadas para comparação dos resultados. No início e a cada 30 dias foram realizadas as determinações de plântulas normais, anormais, sementes não germinadas, massa de cem sementes, teor de água e sementes infestadas. Os testes de arena de livre escolha e repelência foram realizados aos 210 e 240 dias. Os tratamentos não influenciaram a germinação, massa de cem sementes, teor de água. Entretanto, todas as plantas testadas apresentaram efeito repelente sobre o caruncho do feijão.


Subject(s)
Seeds/classification , Insecticides/analysis , Edible Grain/classification , Weevils/classification
2.
J Fr Ophtalmol ; 37(4): 329-36, 2014 Apr.
Article in French | MEDLINE | ID: mdl-24655791

ABSTRACT

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Previously known as the "great imitator", this disease can have numerous and complex manifestations. The ophthalmologist should suspect the diagnosis in patients with uveitis or optic neuropathy and high-risk sexual behavior and/or another sexually transmitted disease (such as HIV) or those presenting with posterior placoid chorioretinitis or necrotising retinitis. Ocular involvement in acquired syphilis is rare, tending to occur during the secondary and tertiary stages of the disease. Syphilis may affect all the structures of the eye, but uveitis (accounting for 1-5% of the uveitis in a tertiary referral center) is the most common ocular finding. Granulomatous or non-granulomatous iridocyclitis (71%), panuveitis, posterior uveitis (8%) and keratouveitis (8%) are often described. In the secondary stage, the meninges and the central nervous system can be affected, sometimes with no symptoms, which justifies performing lumbar puncture in patients with uveitis and/or optic neuropathy. The diagnosis of ocular syphilis requires screening with a non-treponemal serology and confirmation with a treponemal-specific test. Parenterally administered penicillin G is considered first-line therapy for all stages of ocular syphilis. Systemic corticosteroids are an appropriate adjunct treatment for posterior uveitis, scleritis and optic neuritis if ocular inflammation is severe. Prolonged follow-up is necessary because of the possibility of relapse of the disease. With proper diagnosis and prompt antibiotic treatment, the majority of cases of ocular syphilis can be cured.


Subject(s)
Eye Infections, Bacterial , Syphilis , Decision Trees , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/therapy , Humans , Syphilis/diagnosis , Syphilis/therapy , Uveitis/diagnosis , Uveitis/microbiology , Uveitis/therapy
3.
Neurogastroenterol Motil ; 24(12): 1118-e570, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22937879

ABSTRACT

BACKGROUND: Mediators released in the mucosal milieu have been suggested to be involved in visceral hypersensitivity and abdominal pain in patients with irritable bowel syndrome (IBS). However, their impact on myenteric neurons remains unsettled. METHODS: Mucosal biopsies were obtained from the descending colon of patients with IBS and controls. Mucosal mast cells were identified immunohistochemically. The impact of spontaneously released mucosal mediators on guinea pig electrically stimulated longitudinal muscle myenteric plexus (LMMP) preparations was assessed in vitro by means of selective receptor antagonists and inhibitors. KEY RESULTS: Patients with IBS showed an increased mast cell count compared with controls. Application of mucosal mediators of IBS to LMMPs potentiated cholinergic twitch contractions, an effect directly correlated with mast cell counts. Enhanced contractions were inhibited by 50.3% with the prostaglandin D2 antagonist BW A868C, by 31.3% and 39% with the TRPV1 antagonists capsazepine and HC-030031, respectively, and by 60.5% with purinergic P2X antagonist pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid. Conversely, the serotonin1-4, histamine1-3, tachykinin1-3 receptor blockade, and serine protease inhibition had no significant effect. CONCLUSIONS & INFERENCES: Colonic mucosal mediators from patients with IBS excite myenteric cholinergic motor neurons. These effects were correlated with mast cell counts and mediated by activation of prostanoid receptors, TRPV1, and P2X receptors. These results support the role of mucosal inflammatory mediators and mast cell activation in altered motor function of IBS.


Subject(s)
Cholinergic Neurons/metabolism , Culture Media, Conditioned/pharmacology , Intestinal Mucosa/metabolism , Irritable Bowel Syndrome/metabolism , Mast Cells/metabolism , Adult , Animals , Colon/immunology , Colon/metabolism , Colon/pathology , Female , Guinea Pigs , Humans , Intestinal Mucosa/immunology , Intestinal Mucosa/pathology , Irritable Bowel Syndrome/immunology , Irritable Bowel Syndrome/pathology , Male , Mast Cells/immunology , Mast Cells/pathology , Motor Neurons/metabolism , Myenteric Plexus/metabolism
4.
Neurol Sci ; 33 Suppl 1: S185-7, 2012 May.
Article in English | MEDLINE | ID: mdl-22644200

ABSTRACT

Although migraine (MH) and tension type headache (TTH) are the most common and important causes of recurrent headache in adolescents, they are poorly understood and not recognized by parents and teachers, delaying the first physician evaluation for correct diagnosis and management. The purpose of this study is to assess the knowledge about headache impact among the students of a Communication Private High School in Rimini city, and to evaluate the main different types of headaches interfering with school and social day activities. A self-administered questionnaire interview was given to students of the last 2 years of high school; ten items assessed the headache experience during the prior 12 months, especially during school time: the features and diagnosis of headaches types (based on the 2004 IHS criteria), precipitating factors, disability measured using the migraine disability assessment (MIDAS); therapeutic intervention. Out of the 60 students, 84 % experienced recurrent headache during the last 12 months. 79 % were females, aged 17-20 years; a family history was present in 74 % of headache students, in the maternal line; 45 % of subjects were identified as having MH and 27 % TTH; 25 % had morning headache and 20 % in the afternoon; fatigue, emotional stress and lack of sleep were the main trigger factors for headache, respectively in 86, 50 and 50 % of students; 92 % of headache students could not follow the lessons, could not participate in exercises and physical activity because of the headache; none had consulted a medical doctor and the 90 % of all students had never read, listened or watched television about headache. This study remarks on the need to promote headache educational programs, starting from high school, to increase communication between teachers-family-physician and patient-adolescents, with the goal to have an early appropriate therapeutic intervention, improvement of the quality of life and to prevent long-term headache disease in the adult age.


Subject(s)
Migraine Disorders/diagnosis , School Health Services , Schools , Students , Tension-Type Headache/diagnosis , Adolescent , Female , Headache/diagnosis , Headache/epidemiology , Headache/therapy , Humans , Male , Migraine Disorders/epidemiology , Migraine Disorders/therapy , School Health Services/trends , Schools/trends , Surveys and Questionnaires , Tension-Type Headache/epidemiology , Tension-Type Headache/therapy , Young Adult
5.
Epilepsy Behav ; 23(3): 342-7, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22377332

ABSTRACT

The prevalence and characteristics of interictal headache, epilepsy and headache/epilepsy comorbidity were assessed in 858 women and 309 men aged 18-81 years from headache and epilepsy centers in Italy. The research hypothesis was that comorbidity among patients with either disorder would be expected to be higher than in the general population. Interictal headache was diagnosed in 675 cases (migraine 482; tension-type headache 168; other types 25), epilepsy in 336 (partial 171; generalized 165) and comorbidity in 156 (1.6% from headache centers; 30.0% from epilepsy centers). Patients with epilepsy, headache and comorbidity differed in a number of demographic and clinical aspects. However, for both headache and epilepsy, a family history of the same clinical condition was equally prevalent in patients with and without comorbidity. These findings do not support the purported association between headache and epilepsy.


Subject(s)
Epilepsy/epidemiology , Headache Disorders, Primary/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Comorbidity , Cross-Sectional Studies , Epilepsy/diagnosis , Female , Headache Disorders, Primary/classification , Headache Disorders, Primary/diagnosis , Humans , Italy/epidemiology , Male , Middle Aged , Retrospective Studies , Young Adult
6.
Neurol Sci ; 32 Suppl 1: S181-3, 2011 May.
Article in English | MEDLINE | ID: mdl-21533741

ABSTRACT

Undertreatment in patients with primary headaches was evaluated in 600 patients attending 7 headache centres in Lombardy by assessing the rates of acute and prophylactic treatments used before the first visit and the rates of prescription of acute and prophylactic treatments after the visit at the headache centre. Our results clearly showed that most headache patients are likely to receive suboptimal treatments, confirming the utility of headache centres as well as the need for promoting education of GPs and the development of appropriate networks to reduce undertreatment rates, in order to highlight the negative impact caused by primary headache on individuals and on the society.


Subject(s)
Analgesics/therapeutic use , Headache Disorders, Primary/drug therapy , Pain Clinics/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Adult , Female , Humans , Italy , Male
7.
Transplant Proc ; 42(1): 9-14, 2010.
Article in English | MEDLINE | ID: mdl-20172270

ABSTRACT

Chronic intestinal pseudo-obstruction (CIPO), one of the most severe gastrointestinal motility disorders, is a condition characterized by a clinical picture mimicking small bowel occlusion with related symptoms and signs in the absence of demonstrable mechanical obstruction. Analysis of full-thickness biopsy samples may unravel structural changes of the neuromuscular layer involving the whole gut, although the midgut is usually worst affected. Intestinal pseudo-obstruction can occur in association with systemic neurological, endocrine, and connective tissue diseases or malignancy but, when no recognizable etiology is found, CIPO is referred to as idiopathic (CIIPO). The latter form can be diagnosed early in life due to a genetic etiology or in adulthood when a viral origin may be considered. This review addresses the hypothesis that some systemic neurotrophic viral infections can affect the enteric nervous system thereby altering normal peristaltic activity. Available data are reviewed, focusing specifically on herpesviruses or polyomaviruses (JC virus). These suggest that in comparison to a proportion of CIIPO patients, healthy controls rarely harbor viral DNA in the myenteric plexus, leaving open the possibility that a viral infection might have an etiologic role in the development of CIIPO. The review thus provides some new perspectives in the pathophysiology and perhaps targeted treatment of CIIPO.


Subject(s)
Intestinal Pseudo-Obstruction/virology , Adolescent , Animals , Chronic Disease , DNA Virus Infections/complications , DNA Viruses , Herpesviridae , Herpesviridae Infections/complications , Humans , JC Virus , Male , Polyomavirus Infections/complications , Tumor Virus Infections/complications
8.
Neurosci Lett ; 467(3): 203-7, 2009 Dec 31.
Article in English | MEDLINE | ID: mdl-19835930

ABSTRACT

Patients with Parkinson's disease develop motor disturbances often accompanied by peripheral autonomic dysfunctions, including gastrointestinal disorders, such as dysphagia, gastric stasis and constipation. While the mechanisms subserving enteric autonomic dysfunctions are not clearly understood, they may involve the enteric dopaminergic and/or nitrergic systems. In the present study, we demonstrate that rats with unilateral 6-hydroxydopamine lesion of nigrostriatal dopaminergic neurons develop a marked inhibition of propulsive activity compared to sham-operated controls, as indicated by a 60% reduction of daily fecal output at the 4th week of observation. Immunohistochemical data revealed that 6-hydroxydopamine treatment did not affect the total number of HuC/D-positive myenteric neurons in both the proximal and distal segments of ileum and colon. Conversely, in the distal ileum and proximal colon the number of nitrergic neurons was significantly reduced. These results suggest that a disturbed distal gut transit, reminiscent of constipation in the clinical setting, may occur as a consequence of a reduced propulsive motility, likely due to an impairment of a nitric oxide-mediated descending inhibition during peristalsis.


Subject(s)
Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/physiopathology , Gastrointestinal Motility/physiology , Parkinson Disease/complications , Animals , Colon/innervation , Colon/physiopathology , Disease Models, Animal , Enteric Nervous System/metabolism , Enteric Nervous System/pathology , Enteric Nervous System/physiopathology , Gastrointestinal Diseases/metabolism , Ileum/innervation , Ileum/physiopathology , Immunohistochemistry , Male , Neuronal Plasticity/physiology , Nitrergic Neurons/metabolism , Nitrergic Neurons/pathology , Nitric Oxide/metabolism , Oxidopamine , Parkinsonian Disorders/complications , Rats , Rats, Sprague-Dawley
9.
Neurol Sci ; 30 Suppl 1: S129-31, 2009 May.
Article in English | MEDLINE | ID: mdl-19415443

ABSTRACT

Underdiagnosis of primary headaches was evaluated in 504 patients attending six Headache Centres in Lombardy. We found high figures of missed diagnoses (no diagnosis of a specific headache form), and of misdiagnosis (non-concordance between previous diagnoses made by the GP and the final diagnoses given by the headache specialist). We note that underdiagnosis in headache patients may have negative consequences, enhancing the risk of progressive worsening of primary headache syndromes, increasing their impact on individuals and on society, and favouring medication overuse.


Subject(s)
Diagnostic Errors , Headache Disorders, Primary/diagnosis , Adult , Female , Headache/diagnosis , Humans , Male
10.
Gut ; 58(1): 25-32, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18593810

ABSTRACT

BACKGROUND AND AIMS: Chronic idiopathic intestinal pseudo-obstruction (CIIP) is characterised by severe impairment of intestinal propulsive motility that mimics bowel obstruction. JC virus (JCV) is a polyomavirus that can infect brain glial cells causing a fatal disease, but may also be found throughout the normal gastrointestinal tract. The hypothesis that JCV infects the myenteric plexuses of patients with CIIP was tested. METHODS: 10 patients with CIIP and 61 normal specimens (30 ascending colon and 31 ileum) from patients with uncomplicated colon cancer were studied. DNA was extracted from the myenteric plexuses, and JCV T antigen (TAg) DNA and the viral regulatory region were detected by PCR and sequencing. Immunohistochemistry was performed to detect JCV viral protein expression, neuronal and glial markers. Fluorescence in situ hybridisation was performed for cellular localisation of the JCV infection. RESULTS: Clinical studies demonstrated neurogenic impairment, and pathological analyses showed neuropathy in each patient with CIIP. JCV TAg DNA was found in the myenteric plexuses of 8/10 (80%) of the patients with CIIP and 3/31 (9.7%) of the control patients (p<0.001). All samples were JCV Mad-1 strains. Seven of the 10 CIIP specimens expressed both JCV TAg and the JCV viral protein VP1, while none of the controls expressed either. JCV infection co-localised with glial fibrillary acidic protein expression, a marker of enteric glial cells. CONCLUSION: JCV infection occurs in the myenteric plexuses of patients with CIIP. The JCV localisation in enteroglial cells suggests a possible pathological role for this virus in enteric neuropathy.


Subject(s)
Intestinal Pseudo-Obstruction/virology , JC Virus/isolation & purification , Neuroglia/virology , Polyomavirus Infections/complications , Tumor Virus Infections/complications , Adult , Chronic Disease , DNA, Viral/analysis , Female , Humans , Intestinal Pseudo-Obstruction/pathology , Intestinal Pseudo-Obstruction/physiopathology , Intestine, Small/physiopathology , Male , Manometry/methods , Microdissection , Middle Aged , Myenteric Plexus/virology , Young Adult
11.
J Neuroradiol ; 36(4): 185-98, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19081137

ABSTRACT

Whether isolated or associated with craniofacial lesions, traumatic oculo-orbital injuries occur frequently. Radiological evaluation is often necessary to appropriately manage the trauma-related vision loss and oculomotor disturbance. In the emergency setting and after clinical examination, helical CT scanning is the optimal imaging technique for displaying injuries of the orbit and its contents, for determining their severity and for helping the surgeon to choose the best course of treatment. MRI is indicated if the cause of the loss of vision or ocular mobility remain unexplained on CT after ferromagnetic foreign body has been ruled out. Drawing from numerous clinical cases, the purpose of this pictorial review is to demonstrate the wide variety of traumatic lesions of the orbit and eyeball as revealed by helical CT, as well as the limitations of the technique, to provide relevant information for patient care. Helical CT scans remain, in cases of emergency, the optimal imaging technique for the evaluation of oculo-orbital trauma.


Subject(s)
Eye Injuries/diagnostic imaging , Eye Injuries/surgery , Orbit/diagnostic imaging , Orbit/injuries , Tomography, Spiral Computed/methods , Humans
12.
Naunyn Schmiedebergs Arch Pharmacol ; 378(4): 421-9, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18545984

ABSTRACT

Proton pump inhibitors exert their preventive and healing effects on gastropathy induced by nonsteroidal anti-inflammatory drug (NSAIDs) by a dual action: the antisecretory and the antioxidant effect. The latter was investigated by using esomeprazole against indomethacin-induced gastric mucosa lesions in rats and assessed by a histomorphometric analysis. Treatment by intragastric gavage were 1% methocel as vehicle; esomeprazole 10, 30, or 60 micromol/kg; indomethacin 100 micromol/kg; and esomeprazole 10, 30, or 60 micromol/kg plus indomethacin 100 micromol/kg. The evaluation of glutathione (GSH) levels and respiratory chain complex activities [nicotinamide adenine dinucleotide, reduced (NADH)-ubiquinone oxidoreductase, succinate dehydrogenase, cytochrome C reductase, cytochrome oxidase] was performed in the isolated gastric mucosa. Esomeprazole (10-60 micromol/kg) dose dependently reversed, up to complete recovery, the inhibitory effect of indomethacin on GSH levels (approximately 60% inhibition) and mitochondrial enzyme activities (inhibition ranging from 60% to 75%). Indomethacin-induced mucosal injuries were reduced by esomeprazole. Thus, in addition to inhibiting acid secretion, the gastroprotective effect of esomeprazole can be ascribed to a reduction in gastric oxidative injury.


Subject(s)
Esomeprazole/pharmacology , Gastric Mucosa/drug effects , Glutathione/metabolism , Indomethacin/toxicity , Mitochondria/drug effects , Animals , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/toxicity , Anti-Ulcer Agents/administration & dosage , Anti-Ulcer Agents/pharmacology , Dose-Response Relationship, Drug , Electron Transport Complex I/metabolism , Electron Transport Complex II/metabolism , Esomeprazole/administration & dosage , Gastric Mucosa/metabolism , Gastric Mucosa/pathology , Glutathione Disulfide/metabolism , Indomethacin/administration & dosage , Intubation, Gastrointestinal , Male , Membrane Transport Proteins/metabolism , Mitochondria/metabolism , Necrosis , Oxidative Phosphorylation/drug effects , Rats , Rats, Wistar , Spectrophotometry/methods , Stomach Diseases/chemically induced , Stomach Diseases/metabolism , Stomach Diseases/pathology
13.
Br J Pharmacol ; 154(8): 1611-8, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18516071

ABSTRACT

BACKGROUND AND PURPOSE: In human airways, muscarinic acetylcholine receptors (mAChRs) exert a predominant role in the control of airways resistance and anti-muscarinic agents are currently included in the pharmacological treatment of chronic obstructive pulmonary disease (COPD). However, the development of more effective mAChR antagonists is hampered by considerable species variability in the ultrastrucural and functional control of airway smooth muscle, making extrapolation of any particular animal model questionable. This study was designed to characterize the mAChRs in a bronchial preparation from pigs, animals considered to provide close models of human biology. EXPERIMENTAL APPROACH: Smooth muscle bronchial strips were examined by electron microscopy in order to compare their neuromuscular structure with that of human bronchi and used to study the affinity of a series of selective mAChR antagonists, estimated as pKis in competition binding assays with NMS and pA2, by Schild analysis, in contractile experiments. KEY RESULTS: Pharmacodynamic binding parameters and affinity profiles of a series of antagonists were consistent with the presence of a majority of M2 mAChRs along with a minor population of M3 mAChRs. Functionally, the highly significant correlation between postjunctional pA2 affinities and corresponding affinity constants at human recombinant M1-M5 subtypes indicated that smooth muscle contraction in porcine bronchi, as in human bronchi, was dependent on the M3 subtype. CONCLUSION AND IMPLICATIONS: Based on the characterization of mAChRs, isolated porcine bronchi provide an additional experimental model for development of mAChR antagonists for the treatment of human airway dysfunctions.


Subject(s)
Disease Models, Animal , Muscarinic Antagonists/pharmacology , Receptors, Muscarinic/metabolism , Animals , Binding, Competitive , Bronchi/drug effects , Bronchi/metabolism , Bronchodilator Agents/pharmacology , Drug Design , Humans , Microscopy, Electron , Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/physiopathology , Receptor, Muscarinic M2/metabolism , Receptor, Muscarinic M3/metabolism , Receptors, Muscarinic/drug effects , Species Specificity , Swine
14.
Aliment Pharmacol Ther ; 27(12): 1179-86, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18373634

ABSTRACT

BACKGROUND: Dental erosion (DE), which is the irreversible loss of tooth substance that does not involve bacteria ranging from a minimal loss of surface enamel to the partial or complete exposure of dentine by a chemical process, is acknowledged as an established extra-oesophageal manifestation of gastro-oesophageal reflux disease (GERD). However, the real impact of GERD in the genesis of this lesion remains unclear. AIM: To review the existing literature to assess the relationship between DE and GERD. METHODS: Studies that assessed the prevalence of DE in individuals with GERD or vice versa were identified in Medline and the Cochrane Controlled Trials Register via a systematic research strategy. RESULTS: Seventeen studies met the selection criteria. Studies, however, differed greatly as far as design, population methods of diagnosing GERD, duration of follow-up and, consequently, findings. The median prevalence of DE in GERD patients was 24%, with a large range (5-47.5%), and the median prevalence of GERD in DE adults patients was 32.5% (range: 21-83%) and in paediatric population 17% (range: 14-87%). Children with GERD are found by a majority of studies at increased risk of developing DEs in comparison with healthy subjects, as are intellectually disabled people. CONCLUSIONS: This systematic review shows that there is a strong association between GERD and DE. The severity of DEs seems to be correlated with the presence of GERD symptoms, and also, at least in adults, with the severity of proximal oesophageal or oral exposure to an acidic pH. The inspection of the oral cavity in search for DEs should become a routine manoeuvre in patients with GERD.


Subject(s)
Gastric Acid , Gastroesophageal Reflux/complications , Tooth Erosion/etiology , Adolescent , Adult , Child , Child, Preschool , Controlled Clinical Trials as Topic , Dental Plaque Index , Gastroesophageal Reflux/diagnosis , Humans , Infant
15.
Aliment Pharmacol Ther ; 28(1): 25-42, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18410560

ABSTRACT

BACKGROUND: Considerable information has been gathered on the functional organization of enteric neuronal circuitries regulating gastrointestinal motility. However, little is known about the neuropathophysiological mechanisms underlying gastrointestinal motor disorders. AIM: To analyse the most important pathological findings, clinical implications and therapeutic management of idiopathic enteric neuropathies. METHODS: PubMed searches were used to retrieve the literature inherent to molecular determinants, pathophysiological bases and therapeutics of gastrointestinal dysmotility, such as achalasia, gastroparesis, chronic intestinal pseudo-obstruction, Hirschsprung's disease and slow transit constipation, to unravel advances on digestive disorders resulting from enteric neuropathies. RESULTS: Current data on molecular and pathological features of enteric neuropathies indicate that degenerative and inflammatory abnormalities can compromise the morpho-functional integrity of the enteric nervous system. These alterations lead to a massive impairment in gut transit and result in severe abdominal symptoms with associated high morbidity, poor quality of life for patients and established mortality. Many pathophysiological aspects of these severe conditions remain obscure, and therefore treatment options are quite limited and often unsatisfactory. CONCLUSIONS: This review of enteric nervous system abnormalities provides a framework to better understand the pathological processes underlying gut dysmotility, to translate this knowledge into clinical management and to foster the development of targeted therapeutic strategies.


Subject(s)
Autonomic Nervous System Diseases/complications , Enteric Nervous System/physiopathology , Gastrointestinal Motility/physiology , Autonomic Nervous System Diseases/physiopathology , Autonomic Nervous System Diseases/therapy , Constipation/etiology , Esophageal Achalasia/etiology , Female , Gastroparesis/etiology , Hirschsprung Disease/genetics , Humans , Intestinal Pseudo-Obstruction/etiology
16.
Digestion ; 76(3-4): 171-8, 2007.
Article in English | MEDLINE | ID: mdl-18046084

ABSTRACT

Proton pump inhibitors (PPIs) are antisecretory agents that are widely used in the short- and long-term management of gastroesophageal reflux disease (GERD) to relieve symptoms, heal esophagitis, and prevent complications, such as strictures and Barrett's esophagus. The total healthcare costs of GERD are high, especially for maintenance treatment. Therefore, the choice of cost-effective therapeutic options is an ineluctable challenge for public health authorities, third-party payers, and patients. In some European Union countries, a recent trend of public health authorities is to promote the choice of less expensive PPIs, regardless of their antisecretory potency--this in spite of the evidence that newer PPIs provide superior symptom relief and esophageal erosion healing compared to earlier drugs. Several large clinical trials have demonstrated the superiority of esomeprazole over other PPIs at standard doses for both initial and continuous maintenance therapy in patients with moderate/severe erosive esophagitis. The non-erosive GERD poses a major challenge as this condition appears more frequently to be less responsive to PPIs. The use of PPIs with the strongest antisecretory properties might reveal to be more adequate and cost-effective, particularly for this indication.


Subject(s)
Gastroesophageal Reflux/drug therapy , Proton Pump Inhibitors/administration & dosage , Esomeprazole/pharmacology , Esomeprazole/therapeutic use , Gastroesophageal Reflux/economics , Humans , Proton Pump Inhibitors/economics , Randomized Controlled Trials as Topic
17.
Aliment Pharmacol Ther ; 26(2): 195-204, 2007 Jul 15.
Article in English | MEDLINE | ID: mdl-17593065

ABSTRACT

BACKGROUND: Proton pump inhibitors (PPI) therapy 'on-demand' is often used as an alternative to continuous maintenance therapy in gastro-oesophageal reflux disease (GERD). AIM: We conducted a systematic review with the specific objectives to ascertain whether on-demand PPI therapy was effective in preventing symptomatic relapse and to assess the relative efficacy of on-demand vs. continuous PPI maintenance strategy. METHODS: Randomized-controlled clinical trials comparing on-demand PPI vs. placebo or on-demand vs. continuous PPI therapy in GERD patients were identified by searching the Medline database and the Cochrane Controlled Trials Register. RESULTS: Seventeen studies were found which met inclusion criteria. Out of the 17 studies: five investigated exclusively patients with non-erosive reflux disease (NERD), four patients with NERD and mild oesophagitis, two patients with erosive oesophagitis only, and two patients with uninvestigated GERD symptoms, respectively. Four further studies were not investigating the effectiveness of the therapies but primarily pharmacoeconomic or quality of life parameters. CONCLUSIONS: On the basis of the analysis of 17 studies, we can conclude that on-demand therapy with currently available PPI appears to be effective in the long-term management of patients with NERD or mild and uninvestigated forms of GERD, but not in patients with (severe) erosive oesophagitis.


Subject(s)
Esophagitis/drug therapy , Gastroesophageal Reflux/drug therapy , Proton Pump Inhibitors , Drug Administration Schedule , Humans , Proton Pumps/administration & dosage , Randomized Controlled Trials as Topic , Secondary Prevention
18.
Neurol Sci ; 28 Suppl 2: S217-9, 2007 May.
Article in English | MEDLINE | ID: mdl-17508174

ABSTRACT

Psychiatric comorbidity (prevalence and types) was tested in a naturalistic sample of adult patients with pure migraine without aura, and in two control groups of patients, one experiencing pure tension-type headache and the other combined migraine and tension-type headaches. The study population included 374 patients (158, 110 and 106) from nine Italian secondary and tertiary centres. Psychiatric comorbidity was recorded through structured interview and also screened with the Mini International Neuropsychiatry Interview (MINI). Only anxiety and depression were investigated. Psychiatric disorders were reported by 49 patients (14.6%; 10.9% of patients with migraine, 12.8% of those with tension-type headache and 21.4% of those with combined migraine and tension-type headaches). The MINI interview detected a depressive episode in 59.9% of patients with migraine, 68.3% of patients with tension-type headache and 69.6% of patients with combined migraine and tension-type headaches. Depression subtypes were significantly different across groups (p=0.03). Anxiety (mostly generalised) was reported by 18.4% of patients with migraine, 19.3% of patients with tension-type headache, and 18.4% of patients with combined migraine and tension-type headaches. The values for panic disturbance were 12.7, 5.5 and 14.2, and those for obsessive-compulsive disorders were 2.3, 1.1 and 9.4% (p=0.009). Based on these results, psychopathology of primary headache can be a reflection of the burden of the disease rather than a hallmark of a specific headache category.


Subject(s)
Anxiety Disorders/epidemiology , Depressive Disorder/epidemiology , Headache Disorders/epidemiology , Headache Disorders/psychology , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Migraine Disorders/epidemiology , Migraine Disorders/psychology , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/psychology , Panic Disorder/epidemiology , Panic Disorder/psychology , Prevalence , Tension-Type Headache/epidemiology , Tension-Type Headache/psychology
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