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Biomedical subjects

D D Fitch

Publications and source records attributed to D D Fitch.

6 recordsLinked to original sources
PubMed1992

A multicenter, double-blind, randomized, placebo-controlled comparison of nocturnal roxatidine in the treatment of active duodenal ulcer disease. Multicenter Roxatidine Cooperative Study Group.

This multicenter randomized, double-blind, 4-wk study compared the new H2-receptor antagonistic roxatidine (R) to placebo (P) for treatment of endoscopically diagnosed active duodenal ulcer disease. Subjects were evaluated after 2 and 4 wk of treatment. Those whose ulcer was unhealed at 2 wk received 2 more weeks of treatment before final evaluation. Ulcer healing (endoscopically determined) with roxatidine was more effective than placebo at both wk 0-2 (R = 33.9%, P = 21.9%, p = 0.018) and wk 2-4 (R = 68.2%, P = 29.7%, p less than 0.001), with an overall 4-wk effectiveness of 78.9% compared to 44.8% (p less than 0.001). At the end of treatment, average maximum ulcer diameter diminished 83% in R and 50% in P (p less than 0.001). Roxatidine was also more effective than placebo in decreasing abdominal pain (p less than 0.001), decreasing the number of antacid tablets taken for pain relief (p less than 0.001), improving dyspeptic symptoms (p less than 0.001), and permitting return to a normal routine for subjects with previous illness-imposed restrictions on work and/or other daily activities. The profile of laboratory values and adverse experiences demonstrated roxatidine to be safe and well-tolerated. The efficacy of roxatidine as evaluated by the healing rate of duodenal ulcer and reduction in abdominal pain emphasize its value as an addition to the family of H2-receptor antagonists.

Abdominal Pain↗
PubMed1989

Absorption of digoxin from tablets and capsules in subjects with malabsorption syndromes.

The relative steady-state bioavailability of two oral digoxin dosage forms was studied in 17 subjects with malabsorption syndromes. Male subjects received the following treatments in randomized crossover fashion for 14 days: three 0.125-mg digoxin tablets or three 0.1-mg digoxin capsules once daily. Female subjects received digoxin on the same schedule but at two-thirds the dose. Serum and urine samples were collected and analyzed for digoxin by radioimmunoassay, and treatments were compared by evaluating pharmacokinetic parameters. The mean area under the serum concentration versus time curve for tablets (28.1 h.nmol/L [21.9 h.ng/mL]) was smaller (p less than 0.03) than that for capsules (31.1 h.nmol/L [24.3 h.ng/mL]), and the mean maximum serum digoxin concentration for tablets (2.9 nmol/L [2.3 ng/mL]) was lower (p less than 0.02) than that for capsules (4.0 nmol/L [3.1 ng/mL]). There was no difference in cumulative urinary excretion of digoxin between the two treatments. In contrast to previous reports, we observed that digoxin from Lanoxin Tablets appears to be well absorbed in subjects with malabsorption. Nevertheless, these subjects absorbed digoxin from capsules better than from tablets, with the greatest differences occurring in subjects without a colon and in those subjects with the lowest serum carotene concentrations.

Adult↗
PubMed1986

Anal verge and low rectal bleeding. A diagnostic problem.

We describe five patients with lower gastrointestinal bleeding with negative endoscopy who subsequently proved to have sources of bleeding in the rectum close to the anal verge. The failure to identify such sources of bleeding via the endoscope was due to endoscopic geometry within the rectum, limited colonic preparation possible in the massively bleeding bowel, endoscopic inexperience, and a low clinical suspicion for very distal lesions. We discuss appropriate application of the available diagnostic techniques and methods to avoid endoscopic diagnostic failures in low rectal hemorrhage.

Adult↗
PubMed1985

Primary gastrointestinal lymphoma.

We studied 56 patients with primary gastrointestinal lymphoma to determine the manifestations, diagnostic and treatment methods, and patient outcomes. We identified 27 cases of primary gastric lymphoma and 29 cases of lymphoma involving the remainder of the gastrointestinal tract. Initial symptoms were nonspecific and included abdominal pain, weight loss, nausea, and vomiting. Diagnosis was frequently made at operation, with less than half of the patients having endoscopy and biopsy. The predominant histologic type was diffuse histiocytic lymphoma; the second most common type was poorly differentiated lymphocytic lymphoma. Average survival for patients with gastric lymphomas was 38 months, versus 21 months for those with intestinal lymphomas. The most important prognostic factor was the stage of disease at presentation; spread beyond the regional lymph nodes was associated with shortened survival. Comparison of treatment groups was compromised by the varied combinations of therapy used and by the stages and sites of disease. This study points out the need for prospective randomized clinical trials, with comprehensive staging and uniform therapeutic procedures, to identify the best available methods.

Adolescent↗