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Biomedical subjects

D Frommer

Publications and source records attributed to D Frommer.

15 recordsLinked to original sources
PubMed1997

Cleansing ability and tolerance of three bowel preparations for colonoscopy.

PURPOSE: This study was undertaken to determine whether different regimens using sodium phosphate (NaPh) solutions resulted in better bowel cleansing than polyethylene glycol-salt (PEG) solutions and, if so, why. Side-effects and patient acceptability of the different regimens were also investigated. METHODS: A total of 486 patients requiring colonoscopy were randomly assigned to one of three preparations in a single-blind prospective study. The preparations were as follows: Group A, 3 liters of PEG solution taken at 2 p.m. the day before examination; Group B, 45 ml of NaPh solutions taken at 7 a.m. and 7 p.m. the day before examination; or Group C, 45 ml of NaPh taken at 6 p.m. the day before and at 6 a.m. on the morning of, examination. Cleanliness of the bowel was assessed blindly, and patients were questioned about side-effects and preferences for NaPh vs. PEG. RESULTS: Numbers, ages, and gender distribution of patients in the three groups did not differ significantly from each other. Cleanliness scores for the three groups were 3.34 +/- 0.97, 3.22 +/- 0.85, and 4.11 +/- 0.67 (Group C vs. Groups A and B, P < 0.0005; Group A vs. Group B, P > 0.30). Predominance of material in the right side of the colon was found in 13.7, 29.8, and 4.2 percent of Groups A, B, and C, respectively. In the three groups, nausea alone occurred in 3.8, 13.7, and 16.3 percent of patients; vomiting occurred in 0.6, 7.4, and 5.4 percent of patients; and dryness/thirst occurred in 1.9, 17.4, and 20.4 percent of patients, respectively. A total of 80.6 and 82.6 percent of those in Groups B and C who had previously had PEG expressed a preference for taking NaPh (P < 0.001). CONCLUSIONS: The regimen of Group C is significantly better than the regimens of Groups A or B in bowel cleansing. Regimens of Groups A and B did not differ in efficacy of cleansing. It is the timing of taking NaPh in the regimen of Group C rather than its composition that is responsible for its superior cleansing ability compared with PEG. Overnight deposition of small intestinal material in the right colon is partly responsible for the inferior cleansing ability of regimens that involve taking the solution on the day before colonoscopy. Despite a higher incidence of minor side-effects from NaPh than from PEG, a significantly higher proportion of patients preferred NaPh.

Aged↗
PubMed1996

Antigen recognition during progression from acute to chronic infection with a cagA-positive strain of Helicobacter pylori.

We have previously published two reports on acute infection with Helicobacter pylori, one of an adult male and one of a family of four. In the present study, we have isolated H.pylori from each of twin boys in the family and compared these by use of random amplified polymorphic DNA PCR. In addition, we have monitored the antibody response over time of the family and the adult male by Western blotting (immunoblotting) with two different strains of H. pylori as the antigen and by use of a commercial kit. The acutely infected twin boys were infected by an identical strain of H. pylori. The twin boys responded to antigens of 19, 26.5, and 29 kDa 30 days after the initial diagnosis, with recognition of 43-to 49-, 66-, 69-, and 87-kDa antigens by day 63. One twin responded to the CagA antigen on day 63, whereas the other responded on day 857. Antibody to the CagA antigen was not detected by use of the infecting strain, UNSW-RU1. Investigation of UNSW-RU1 revealed the presence of cagA. In two acutely infected adults (one, the father of the boys), the initial response to a 45-kDA antigen was later followed by responses to 19-, 29-, 49-, 60-, 77-, and 84-kDa antigens. Sera from the twins' younger sister, born 17 months after the twins acute episode, indicated that she also had become infected. This report supports intrafamilial transmission of H. pylori. Initial antibody responses in the children were to small-molecular-size antigens; in the adults, the initial responses were to larger-molecular-size antigens. The pattern of the serological response differs according to the antigen used. This has implications in regard to international data comparisons.

Acute Disease↗
PubMed1986

Diagnosis of IBS.

Explore the source record for details and available documents.

Colonic Diseases, Functional↗
PubMed1985

Immunological detection of occult blood in bowel cancer patients.

The ability of a highly sensitive gel immunodiffusion technique to detect faecal occult blood in control subjects and in patients with colorectal carcinoma, was compared to that of Hemoccult II. In 1,200 samples from 200 control subjects, 3.3% were positive by the immunological technique, 5.0% by Hemoccult II with rehydration and 2.3% without rehydration, representing 7.5%, 10.5% and 5.0% of subjects, respectively. A total of 2 carcinomas and 6 polyps were detected in the 27 positive subjects. False positive results were 4.5% for the immunological technique, 7.5% and 3.0% for Hemoccult II with and without rehydration. All 40 patients with colorectal carcinoma had at least 1 in 6 samples positive on immunological testing and 79.2% of all samples were positive. With Hemoccult II, without rehydration, 52.1% of samples and 71.8% of patients were positive. These values increased to 66.3% and 87.5% with rehydration. It is concluded that: (i) The proportion of false positive results on immunological testing is low enough to allow screening of populations for colorectal carcinoma using this technique. (ii) Using 6 faecal samples, this technique detected bleeding from 100% of colorectal carcinomas in the study.

Aged↗
PubMed1981

Comparison of five guaiac resin paper tests for demonstrating the presence of blood in faeces.

Four recently available kits of guaiac resin-impregnated paper for demonstrating the presence of blood in faeces were compared with Hemoccult II in in vitro testing. Hemo-FEC most closely resembled Hemoccult II in its sensitivity with freshly prepared kits and kits prepared one week earlier with or without rehydration before testing. Gamma Fe-Cult and Fecatest were more sensitive than Hemoccult II whereas Camco-Pac Guaiac was much less sensitive. Rehydration of kits prepared several days beforehand appears to be useful in restoring sensitivity lost by all the kits tested.

Guaiac↗
PubMed1977

Kayser-Fleischer-like rings in patients without Wilson's disease.

Three patients, one with cryptogenic cirrhosis, one with active chronic hepatitis and one with neonatal hepatitis, were found to have corneal pigmentation rings indistinguishable from early Kayser-Fleischer rings on slit lamp examination. They did not have the clinical features of Wilson's disease and their serum copper and ceruloplasmin concentrations were normal. Urinary copper excretion rates and hepatic concentrations were only slightly raised but were below the range found in symptomatic Wilson's disease. It is concluded that the Kayser-Fleischer ring would no longer be considered as pathognomonic of Wilson's disease.

Adult↗