SUMMARY Cisapride is a newly developed substance that stimulates gastrointestinal motility, possibly enhancing acetylcholine release in the gut wall. The aim of our study was Received for publication 1 June 1984 oesophageal motility in healthy human subjects. It was realised that the lower oesophageal sphincter pressure is not constant. In the fasting state the lower oesophageal sphincter pressure shows substantial fluctuations which appear to be related to the interdigestive migrating complex.3 4 Furthermore, the lower oesophageal sphincter pressure changes after consumption of a meal, the effect depending on the composition of the meal.5-Whether amplitude and duration of the contractions in the oesophageal body are likewise related to motility patterns in the upper gut is not known. Therefore, the study was designed such that the effect of cisapride on oesophageal contractions and lower oesophageal sphincter pressure could be OCH3 OCH3
Nosocomial infections are a major problem in intensive care patients. Thirty-nine patients, requiring intensive care for 5 days or more (mean 15.8 days) were prospectively investigated, to determine the relation between colonisation and nosocomial infection. Thrice weekly, cultures from the oropharynx, respiratory and digestive tract were obtained. Colonization with aerobic gram-negative microorganisms of the oropharynx, respiratory and digestive tract significantly increased during the stay in the Intensive Care Unit. In 29 patients (74%) 78 nosocomial infections were diagnosed. The most frequent nosocomial infections were pneumonia (26 patients, 66.6%), catheter-related bacteraemia (11 patients, 28.2%), and wound infections (7 patients, 17.9%). In 59 instances (75.6%), colonization with the same potential pathogenic microorganism preceded the nosocomial infection. The overall mortality was 25.6% (10 patients), bacteraemia with aerobic gram-negative microorganisms being the cause of death in 7 patients.
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