Exploring the link between gastrointestinal complications and over-the-counter analgesics: current issues and considerations.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most widely used classes of drug worldwide, with as many as 8% of the global adult population taking prescription NSAIDs at any given time. It is well documented that NSAID-related gastrointestinal (GI) effects are a significant cause of morbidity and mortality. Data from Australia alone suggest that each year there may be as many as 2300 serious GI complications and 300 deaths.

Effect of venesection on bone mineral density in an eugonadal woman with haemochromatosis.

Background: A 41-year-old premenopausal woman with newly diagnosed haemochromatosis was found to have osteopenia on screening bone mineral densitometry.

Methods And Results: Liver biopsy showed grade 3 haemochromatosis with an hepatic iron index of 4. Investigation for secondary factors for osteopenia revealed no cause.

Cyclic AMP-dependent anion secretion in human small and large intestine.

Cyclic AMP-dependent Cl- secretion is the major secretion pathway in human intestine. The aim of the present study was to examine mechanisms involved in cAMP-dependent anion secretion in human small and large intestine. Surgical resection specimens from both jejunum and distal colon were studied under short circuited conditions.

Modulation of host response to Escherichia coli o157:H7 infection by anti-CD18 antibody in rabbits.

Background/aims: Escherichia coli O157:H7 infection induces diarrhea, severe colitis, and colonic electrolyte transport abnormalities characterized by decreased Na absorption and Cl secretion. The aim of this study was to examine the role of the host inflammatory response in inducing distal colonic transport changes during infection with E. coli O157:H7.

Decreased uptake of L-cystine by duodenal brush border membrane vesicles from patients with cystinuria.

Background: The pathophysiology of cystinuria remains unclear. Decreased absorption of L-cystine across brush border membranes of small intestinal and renal proximal tubular epithelial cells is likely but has not been directly demonstrated.

Aims: To compare the rates of L-cystine transport by isolated duodenal brush border membranes of normal individuals and patients with cystinuria.

The effect of enterohemorrhagic Escherichia coli O157:H7 on intestinal structure and solute transport in rabbits.

Background: The effect of enterohemorrhagic Escherichia coli O157:H7 infection on intestinal morphology and solute transport was examined.

Methods: New Zealand white rabbits, aged 10 days, were infected with E. coli strain EDL933 (O157:H7 containing the 60-megadalton plasmid-encoding adhesion factors VT1 and VT2) and compared with controls.

Does iron affect osteoblast function? Studies in vitro and in patients with chronic liver disease.

In order to study the role of trace elements as potential osteoblastic toxins, we measured bone aluminum, copper, and iron in 106 ambulant patients with histologically proven liver disease. We used analytical and histochemical methods and we correlated our results with serum biochemistry, forearm and spinal bone density, and dynamic bone histomorphometry. Patients with chronic liver disease had higher iron-stained perimeters than control subjects (P less than 0.

Abnormal epithelial transport in cystic fibrosis jejunum.

Abnormal epithelial electrolyte transport has been identified in a range of cystic fibrosis (CF) organs and appears to account for the various clinical manifestations of the disease. The aim of this study was to further define the Cl- secretion defect in CF jejunum. Excised jejunum was obtained from 11 CF patients and 12 controls.

Effects of testosterone and venesection on spinal and peripheral bone mineral in six hypogonadal men with hemochromatosis.

To measure the effect of testosterone replacement and venesection on spinal and peripheral bone mineral we prospectively studied six hypogonadal men and six eugonadal men with idiopathic hemochromatosis for 24 months. Venesections were performed every week on all patients, and intramuscular injections of testosterone were administered every 3 weeks to the hypogonadal men only. Bone mineral was measured by quantitative computed tomography in the spine and by single-photon absorptiometry in the forearm.

Phenylthiocarbamide taste sensitivity in chronic peptic ulcer.

Ability to taste phenylthiocarbamide is genetically determined and has been investigated as a possible genetic marker for disease. This study examined phenylthiocarbamide taste sensitivity in gastric and duodenal ulcer disease. The study sample included 164 patients with gastric ulcer, 134 with duodenal ulcer, and 299 community controls.

Osteoporosis and skeletal fractures in chronic liver disease.

In order to determine the prevalence and severity of hepatic osteodystrophy by non-invasive means we compared 115 consecutive ambulant patients with histologically proven chronic liver disease to 113 age and sex matched control subjects. Methods used included the assessment of fracture prevalence rates, spinal radiography, and measurements of bone mineral density in the spine and the forearm. Spinal and peripheral fractures were more prevalent in the patients than in the control subjects (p less than 0.

Serum vitamin D metabolites are not responsible for low turnover osteoporosis in chronic liver disease.

We measured the concentrations of vitamin D-binding protein (DBP), total 25-hydroxyvitamin D, total 1,25-dihydroxyvitamin D [1,25-(OH)2D], and free 1,25-(OH)2D in sera of 107 patients with histologically proven chronic liver disease. Bone density measurements and dynamic skeletal histomorphometry were also performed. Osteoporosis, as defined by arbitrary criteria, was found in 42 patients (39%), while no patient had osteomalacia.

Osteoporosis in hemochromatosis: iron excess, gonadal deficiency, or other factors?

Study Objective: To define the prevalence, severity, type and pathogenesis of osteopenia in idiopathic hemochromatosis.

Design: Prospective study conducted over 18 months.

Setting: Tertiary care center.

Ethanol reduces bone formation and may cause osteoporosis.

Introduction: The etiology of ethanol-associated osteopenia is not fully understood. In order to define the role of ethanol in the pathogenesis of hepatic osteodystrophy, we compared two groups of alcoholic patients with histologically established alcoholic liver disease.

Patients And Methods: Twenty-eight patients currently drinking ethanol ("drinkers") and 12 claiming not to have consumed any ethanol for at least six months ("abstainers") were enrolled in the study.

Hepatic osteodystrophy. Static and dynamic bone histomorphometry and serum bone Gla-protein in 80 patients with chronic liver disease.

To study the pathogenesis of osteoporosis in patients with chronic liver disease, we performed dynamic bone histomorphometry and measured serum bone Gla-protein in 80 patients with various types of chronic liver disease. These results were compared with results obtained in 40 healthy controls. Mean trabecular bone volume and mean trabecular thickness were significantly reduced in both men and women with chronic liver disease (p less than 0.

Fibrolamellar carcinoma as a cause of bile duct obstruction.

Obstructive jaundice due to growth within bile ducts of hepatocellular carcinoma is uncommon and usually a manifestation of advanced, lethal tumour. We report a case of fibrolamellar carcinoma of the liver presenting with obstructive jaundice, caused by tumorous permeation of the left hepatic duct with migration of tumour fragments into the common bile duct. Immunocytochemical and ultrastructural features are described.

Acute hepatitis and Brucella melitensis infection: clinicopathological findings.

The clinical and pathological findings in a patient who had acute hepatitis caused by Brucella melitensis are described. Antibiotic therapy induced a good clinical and biochemical response, although a relapse occurred. Brucellosis must be considered in the differential diagnosis of pyrexia of unknown origin, particularly if associated hepatic involvement is present.

Protective effect of enprostil against aspirin-induced gastroduodenal mucosal injury in man. Comparison with cimetidine and sucralfate.

A single-blind endoscopic study was undertaken to test the relative efficacy of enprostil, a synthetic analogue of prostaglandin E2, cimetidine, and sucralfate in the prevention of aspirin-induced gastroduodenal mucosal injury. Fifty healthy, non-smoking male volunteers completed the study after having been randomly assigned to receive two weeks of therapy with one of the following regimens: enprostil 35 micrograms twice daily; enprostil 35 micrograms in the morning; cimetidine 200 mg three times daily and 400 mg at night; sucralfate 1 g four times daily; or placebo. In the second week, aspirin (900 mg three times daily) was also administered.

Uptake and subcellular localisation of bismuth in the gastrointestinal mucosa of rats after short term administration of colloidal bismuth subcitrate.

Despite the topical action of colloidal bismuth subcitrate in promoting the healing of peptic ulcers, slight absorption of bismuth from the gastrointestinal tract has been reported in colloidal bismuth subcitrate-treated animals and man. The uptake and subcellular distribution of bismuth by the gastrointestinal tract of rats after 24 hours of colloidal bismuth subcitrate administration was studied. Mucosal uptake of bismuth (mean +/- SEM nmol/g protein) by gastric fundus (8.

Cimetidine reduces the risk of rebleeding from duodenal ulcers displaying signs of recent haemorrhage.

The presence of endoscopic signs of recent haemorrhage (SRH) greatly increases the risk of rebleeding from peptic ulcers. Fifty-five patients with acute bleeding from chronic duodenal ulcers with SRH completed a randomized double-blind trial to assess the effect of administration of cimetidine (800 mg daily intravenously for 2 days, then 1000 mg daily orally for 10 days in divided doses) versus placebo on rebleeding and need for emergency surgery. In the cimetidine group (n = 29), 5 rebled, compared with 11 receiving placebo (n = 26) (p less than 0.