BACKGROUND Ventilator-associated pneumonia (VAP) is the most common infection in intubated critically ill patients. Microaspiration of the contaminated gastric and oropharyngeal secretions is the main mechanism involved in the pathophysiology of VAP. Tracheal cuff plays an important role in stopping the progression of contaminated secretions into the lower respiratory tract. Previous in vitro s...

The escape ofacid gastric secretions from thestomach, in certain circumstances, is potentially destructive to the mucosae of the oesophagus and the duodenum. In the duodenum the pyloric sphincter plays a part in controlling gastric emptying, and further protection from the harmful effects of acid is offered by inhibitory mechanisms stimulated by duodenal acidification (Johnston and Duthie, 1965...

Intrinsic factor antibody may sometimes be concealed in the gastric secretions of pernicious anaemia subjects, being complexed with residual amounts of intrinsic factor.A method is described for dissociating intrinsic factor from its antibody. Antibody to the vitamin-B(12)-binding site of intrinsic factor was identified in 16 (57%) out of 28 samples of pernicious anaemia gastric juice after dis...

Because of a report of necrotizing enterocolitis and death of a neonate from cyclopentolate eyedrops, we prospectively studied the effects of cyclopentolate 0.5% and 0.25% ophthalmic solutions and of a placebo on gastric volume and acid secretions in 20 pre-term infants. Placebo and cyclopentolate 0.25% eyedrops had no significant effect on the tested gastric functions. However, cyclopentolate ...

Feeding-related adverse events after percutaneous endoscopic gastrostomy (PEG) such as aspiration pneumonia can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes with gastric decompression function may improve outcomes by circumventing gastric passage during enteral nutrition and improving drainage of excessive gastric secretions. Thi...

OBJECTIVE: To determine the effect of the prokinetic agent cisapride in the prevention of aspiration of gastric contents. DESIGN: A prospective randomized two-period crossover study. SETTING: Fourteen-bed polyvalent intensive care unit in a University Hospital. PATIENTS: Eighteen intubated, mechanically ventilated patients who were seated in a semirecumbent position were studied. METHOD: Tc-99 ...

The human gastric parietal cell synthesizes and secretes intrinsic factor (IF) and acid. In contrast to the cellular mechanisms of acid secretion, little is known about the mechanisms of IF secretion. To elucidate these mechanisms we obtained gastric secretions and sequential fundic biopsies from three subjects before and after pentagastrin stimulation (6 microgram/Kg s.c.). IF was localized in...

In this study, we investigated the relationship between gastric emptying and duodenal events in patients with the Zollinger-Ellison syndrome due to a gastrinoma. Like the inhibitory effect of a meal on gastric secretion (described in a companion paper), postprandial inhibition of gastric emptying reduces fractional gastric emptying rates to normal during the first two hours after a meal. Gastri...

Nonulcer dyspepsia is a common clinical syndrome whose etiology is unknown. The sensitivity of the gastric mucosa to acid and duodenal contents in 18 patients with nonulcer dyspepsia was studied. The patients had a normal upper gastrointestinal endoscopy and biopsy specimens were obtained for determination of Helicobacter pylori status. Fifteen of the 18 patients were infected with H. pylori. A...

Trypanosoma cruzi is an intracellular parasite transmitted from a reduviid insect vector to humans by exposure of mucosal surfaces to infected insect excreta. We have used an oral challenge murine model that mimics vector-borne transmission to study T. cruzi mucosal infection. Although gastric secretions have microbicidal activity against most infectious pathogens, we demonstrate that T. cruzi ...