Biomedical subjects

D E Vidican

Publications and source records attributed to D E Vidican.

3 recordsLinked to original sources

PubMed1997

Short chain fatty acid rectal irrigation for left-sided ulcerative colitis: a randomised, placebo controlled trial.

BACKGROUND: Short chain fatty acid (SCFA) deficiency is associated with colitis in animals and humans, and the mucosal metabolism of these compounds is decreased in ulcerative colitis. AIMS: To assess the efficacy of topical SCFA treatment in ulcerative colitis. PATIENTS AND METHODS: 103 patients with distal ulcerative colitis were entered into a six week, double-blind, placebo controlled trial of rectal SCFA twice daily; patients who were unchanged on placebo were offered SCFA in an open-label extension trial. RESULTS: Of the 91 patients completing the trial, more patients in the SCFA treated than in the placebo treated group improved (33% v 20%, p = 0.14, NS). Those on SCFA also had larger, but statistically non-significant, reductions in every component of their clinical and histological activity scores. In patients with a relatively short current episode of colitis (< 6 months, n = 42), more responded to SCFA than to placebo (48% v 18%, p = 0.03). These patients also had larger, but statistically non-significant, decreases in their clinical activity index (p = 0.08 v placebo). Every patient who improved used at least five of six of the prescribed rectal SCFA irrigations, whereas only 37% who did not improve were as compliant. In the open-label extension trial, 65% improved on SCFA; these patients also had significant reductions (p < 0.02) in their clinical and histological activity scores. CONCLUSIONS: Although SCFA enemas were not of therapeutic value in this controlled trial, the results suggest efficacy in subsets of patients with distal ulcerative colitis including those with short active episodes. Prolonged contact with rectal mucosa seems to be necessary for therapeutic benefit.

Acute Disease↗

PubMed1990

Ileal duplication cyst causing massive bleeding in a child.

Intestinal duplication is a rare congenital anomaly; nonetheless, it comprises more than half of all alimentary duplication disorders. Our case report describes the hemorrhagic sequelae of this entity with surgical and pathologic findings. A review of anatomical classification, embryology, and natural history of duplication cyst follows; differentiating characteristics of duplication cyst versus Meckel's diverticulum are outlined. Intestinal duplication cyst should be considered in the differential diagnosis of GI bleeding, especially in children.

Child↗

PubMedDate not supplied

A supervised training program in flexible sigmoidoscopy: evaluating skills from residency training to clinical practice.

To assess the effectiveness of a training program in flexible sigmoidoscopy for family practice residents, we prospectively studied the performance of four residents during their training and after graduation. One hundred and four training exams performed with the assistance of an experienced gastroenterologist were compared with 118 unassisted post-training, post-residency exams. The mean depth of insertion for the post-training period was 51.1 +/- 1.2 cm, which was significantly greater (P less than .05, Student's t test) than the mean training period depth of 47.6 +/- 1.2 cm. There was no significant difference in the identification of polyps or cancer between the training and post-training periods. The mean duration of an exam was 17.3 +/- 0.6 minutes in the post-training period. No significant complications were encountered in either period. The residency trained family physicians obtained results similar to those reported by trained endoscopists in depth of examination and pathology detected, although their examinations required more time. We conclude that this model of training was effective in the development of flexible sigmoidoscopy procedural skill for family practice residents.

Clinical Competence↗