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Biomedical subjects

A Mittelstaedt

Publications and source records attributed to A Mittelstaedt.

8 recordsLinked to original sources
PubMed1995

[Ranitidine and clarithromycin for eradication of Helicobacter pylori in patients with duodenal ulcer].

To compare the efficacy of ranitidine (CAS66357-35-5, Sostril) in combination with clarithromycin (CAS 81103-11-9, Cyllind) against H. pylori, a controlled randomized double-blind study was carried out. Fourty duodenal ulcer patients were treated either with ranitidine 150 mg b.i.d. and clarithromycin 500 mg q.i.d. (20 patients, group 1) or ranitidine 300 mg q.i.d. and clarithromycin 500 mg q.i.d. (20 patients, group 2) for 14 days. Both treatment groups received an additional treatment with ranitidine 300 mg daily for another 14 days. Endoscopy 6 weeks after the beginning of the trial showed complete ulcer healing in all patients. The control of H. pylori status done by CLO (Campylobacter-like organism) test and histology yielded an eradication rate of 84% (group 2) and 61% (group 1) in patients with duodenal ulcer disease treated with ranitidine and clarithromycin. Whether higher suppression of gastric acidity with a higher dose of ranitidine in combination with the antibiotic clarithromycin presents clear advantages in eradication of H. pylori should be investigated in further studies.

Adult↗
PubMed1983

[Treatment of reflux esophagitis with sucralfat].

In a multi-centre placebo-controlled double-blind study, the therapeutic effectiveness of sucralfate (aluminium sucrose sulphate, four times 1 g daily) was tested on 66 out-patients with endoscopically confirmed reflux oesophagitis. After 12 weeks of treatment complete healing occurred in 72% of the sucralfate group, and in a further 14% there was improvement. In the placebo group the healing rate was 40%, with improvement in a further 20%. Serious side-effects did not occur. Sucralfate treatment was especially effective in patients with signs of high-grade inflammation (stage III of Savary and Miller) unsuccessfully treated with other drugs. Contrary to previously available drugs, sucralfate is effective also in lesions caused by alkaline reflux and is thus a useful addition to the hitherto unsatisfactory means of treatment.

Alginates↗
PubMed1979

Incidence of epithelial dysplasia after partial gastric resection.

Because of the higher risk of cancer in the gastric stump, an increased incidence of pre-cancerous conditions should be exspected also in the resected stomach. Therefore, a combined endoscopic and bioptic study was performed in order to investigate the incidence of dysplasias in the gastric stump after resection for benign conditions. Among 101 patients with gastric resection, 2 cases were excluded from this study because of preceeding gastric cancer and one because of cancer of the gastric stump. In 43 of the remaining 98 patients, a Billroth-I-resection (gastroduodenostomy) had been carried out. In the remaining 55 patients with a Billroth-II-resection (gastroenterostomy) 9 had an additional enteroanastomosis of Braun whereas in the residual 46 patients this enteroanastomosis was lacking. This distinction was made because of a facultative or obligatory bile reflux. The average age of the B-I-group was 68 years, of the B-II-group with enteroanastomosis 69 years, and the B-II-group without enteroanastomosis 62 years. A non-operated group matched for age served as control group. Biopsy particles from the anastomotic region were gained by endoscopy and cut in step sections. The classification of dysplasias (degree I-III) followed the criteria given by Nagayo as modified by Grundmann. Inflammatory reactive changes were separated from these. A few changes could not be classified definitely and were listed as unclassified dysplasia. While dysplastic changes of low degree were quite numerous in every group, the dysplasias of higher degree were only found in a small number of cases. In the 46 cases with B-II-resection without Braun's enteroanastomosis, there were 5 dysplasia II and 3 dysplasia II. In the 9 cases with B-II-resection and with Braun's enteroanastomosis, there was 1 dysplasia I and no dysplasia III. In the 43 patient with B-I-resection only 2 dysplasia II and no dysplasia III were found. In the control group of 98 patients matched for age there were only 5 cases with dysplasia I and 1 case with dysplasia III. Patients with higher degrees of dysplasia showed a higher age and a longer interval after operation. There was also a correlation between higher degrees of dysplasia and severe atrophic changes in the mucosa. Correlating the degree of dysplasia with the reason for gastric resection, most of the dysplastic changes occurred in patients resected for gastric ulcer, whereas cases resected for duodenal ulcer showed only 2 dysplasias I. The discussion refers to the few data about dysplasia of the gastric stump available from the literature. Atrophic and increased regenerative changes obviously play a role in the pathogenesis of these dysplastic changes. As a causative factor the role of bile reflux is discussed. A further diagnostic and therapeutic regimen for the different forms of dysplasia is proposed.

Aged↗
PubMed1976

[Therapy of duodenal ulcer. Comparative study on the hospital treatment of duodenal ulcer under endoscopic control of progress with and without drug support].

In a controlled study of 4 weeks--performed on 3 groups of 15 hospitalized patients each with endoscopically demonstrated florid duodenal ulcers--the healing process was checked by endoscope after 14 days and 4 weeks. The first group was treated with the preparation Caved-S, the second received an antacid mixture, and the third group was at first given no specific therapy but a placebo and later on an additional small quantity of antacids. The quickest relief of the pain symptoms was seen in the group treated with Caved-S. Healing was assessed endoscopically after the scheme of Ohmori and Miva and yielded after 14 days a varying number of healing stages for all 3 groups; after 4 weeks there was positive healing-up in a varying number of patients. All 45 patients were clearly improved after 4 weeks. The healing rate in those who had received Caved-S was slightly better than in those who had been treated with antacids and significantly better than in those patients who had been given small quantities of antacids only later on. It becomes apparent again that hospitalization alone leads to ulcer healing in over 60% of cases, which excludes the evidence of an influence of drugs.

Adult↗
PubMed1976

[Therapy of ulcus ventriculi with Caved-S. Use of the gastrocamera for diagnosis and control of therapy].

36 patients with a ventricular ulcer demonstrated by endoscopy and secured by histology, were given 2 tablets Caved-S 4 times a day for 4 weeks. Clinical parameters were subjective complaints, such as pain and heartburn, which after a relatively short time, many patients declared to have diminished or ceased completely. Objective parameters were endoscopic explorations before beginning of the treatment, i.e. gastroscopy and biopsy, examinations by gastro-camera and in some cases chromography to exclude a possible malignancy. The control examinations were performed almost exclusively by gastro-camera, and that after 2 and 4 weeks. The ulcer healing stage could be clearly defined after Ohmori and Miwa (1971), its localisation and size were also recorded. Altogether it can be said, that the preparation Caved-S, by a working-principle not as yet exactly defined in all details, effects rapid healing endoscopically provable, but that ulcers with a special localisation, e.g. in the angulus-area of the posterior wall, require a longer healing time according to expectation. Clinically relevant side effects were not observed. Thus it can be concluded that Caved-S is very suitable for the treatment of ventricular ulcers. The preparation has a spasmolytical component leading quickly to freedom from pain, and a protective component effecting a healing tendency which can be demonstrated by endoscopic methods. It must be said, however, that this protective healing-promoter factor has not yet been defined pharmacologically.

Aluminum Hydroxide↗