Biomedical subjects
B Billington
Publications and source records attributed to B Billington.
Role of maintenance sucralfate in prevention of duodenal ulcer recurrence.
Fifty-nine patients who had duodenal ulcers that were healed following sucralfate administration in a dose of 1 g four times a day were randomly entered into a double-blind, placebo-controlled, 12-month maintenance study to determine whether sucralfate 1 g twice daily prevents recurrence of duodenal ulceration. Patients were assessed endoscopically at four, eight, and 12 months after healing or earlier if clinical relapse occurred. Of the original 59 patients, 53 showed healing with six weeks of therapy, and the remaining six patients required 10 weeks of treatment. Nine patients were subsequently lost to follow-up because of non-compliance, leaving 50 patients for the analysis, 24 who received sucralfate and 26 who received placebo. There were 10 ulcer recurrences in the sucralfate group and the ulcers in 14 (58 percent) patients remaining healed at the end of 12 months. In contrast, there were 21 recurrences in the placebo group with the ulcers in five patients (19 percent) remaining healed at 12 months. Patients who received placebo experienced recurrence more quickly than those who received sucralfate and there was no difference between the two groups in terms of symptomatic and asymptomatic recurrence. There was no alteration in serum aluminium and phosphate levels throughout the study. Smoking seemed to have no adverse effect on recurrence once initial healing had been achieved. Sucralfate is, therefore, an effective and safe maintenance treatment for duodenal ulcer disease.
Prevention of duodenal ulcer occurrence. Double-blind comparison of ranitidine and cimetidine.
We compared ranitidine and cimetidine in maintenance therapy to prevent duodenal ulcer recurrence over a period of 24 months. Endoscopic examination at the end of 12 months showed that the ulcers of 26 of 31 patients (84%) on ranitidine in a dose of 150 mg remained healed and of 10 of 13 (77%) patients on cimetidine in a dose of 400 mg at night remained healed. Thirty-four patients continued in an open evaluation of ranitidine in a dose of 150 mg at night for a further 12-month period, and during this time there were four further recurrences. Life table estimates of duodenal ulcer recurrence during the 2-year period showed no significant difference between the two forms of treatment.
The treatment of macular holes by pars plana vitrectomy and internal air/SF6 exchange.
The results of a series of patients with full-thickness macular holes treated by pars plana vitrectomy are described. A air/gas mixture is used to tamponade the retinal hole and no adhesion is applied. Eleven eyes, including six high myopes, were treated using this method and sustained reattachment was achieved in eight eyes (73%). Three cases failed due to the presence of preretinal membrane formation and retinal shortening. This method is technically easy, allows good tamponade of the retinal hole with controlled internal drainage of subretinal fluid, and appears much safer than previously described techniques.
Residents' functioning and staff perceptions of 'ease of management' in two types of old peoples' homes.
Two hundred and forty-five residents in six old peoples' homes of different types were assessed for level of confusion, behavioural disturbance and whether they were most or least difficult to manage. Results show that: Residents in non-unit homes differ from those in unit establishments studied in being significantly more confused and behaviourally disturbed. EMI residents are more confused than non-EMI. Behaviourally, the two groups do not differ significantly. In the non-unit homes only, the cognitive and behavioural measures used in this study clearly distinguish 'difficult' residents from 'easy' ones. The significance of these findings is discussed.
The degenerative diseases as a national health problem.
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