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Biomedical subjects

D G Colin-Jones

Publications and source records attributed to D G Colin-Jones.

At least 55 records · Page 3Linked to original sources
PubMed1986

Endoscopic removal of a large ulcerated Brunner's gland adenoma.

A case of a large and ulcerated Brunner's gland adenoma presenting as chronic blood loss and resected endoscopically with complete resolution of symptoms. The pathological features of the tumour and the therapeutic approaches are discussed with particular reference to endoscopic surgery.

Adenoma↗
PubMed1985

Postmarketing surveillance of the safety of cimetidine: mortality during second, third, and fourth years of follow up.

A previous report analysed the pattern of mortality during the first year of follow up among 9928 patients taking cimetidine who were recruited to a postmarketing drug surveillance study in Glasgow, Nottingham, Oxford, and Portsmouth. A further analysis has now been conducted extending the period of follow up to four years. The 12 month report noted that cimetidine was being given, knowingly or unknowingly, in the late stages of many diseases and also to counter the adverse gastric effects of other drugs used in the treatment of serious disorders. This finding was underlined by a steady fall in the excess death rate among cimetidine users with increasing length of follow up, such that by the fourth year the pattern of observed deaths was not much different from that expected on the basis of national rates. Some excess of observed over expected deaths from gastric cancer, lung cancer, and urinary disorders was still apparent after four years of follow up, but there was no evidence that cimetidine was responsible. Indeed, no fatal disorder emerged as being associated with cimetidine during the follow up period. Deaths from the complications of disease related to gastric acid occurred in only 38 of the 9928 subjects over the four years. These findings provide further evidence of the safety of cimetidine.

Aged↗
PubMed1984

Reducing overnight secretion of acid to heal duodenal ulcers. Comparison of standard divided dose of ranitidine with a single dose administered at night.

This study was undertaken to assess the clinical usefulness of a single nighttime dose of ranitidine in the short-term healing of duodenal ulcer. One hundred and nine patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with ranitidine, either 150 mg twice daily or 300 mg as a single nighttime dose for four weeks, in a prospective double-blind, double-placebo trial. Of the 102 patients who completed the study, 48 of 57 (84 percent) healed endoscopically on ranitidine 150 mg twice daily, and 43 of 45 (96 percent) healed on 300 mg at nighttime (Mantel-Haenszel test without continuity correction: X2 = 2.9, p = 0.09). One patient treated with ranitidine 150 mg twice daily had a transient episode of cholestatic hepatitis that did not necessitate stopping the drug; in this patient the ulcer healed after 28 days of treatment. There were no other unwanted effects in either group and no significant abnormal biochemical or hematologic changes. This study shows that ranitidine 300 mg given as one nighttime dose is as safe as 150 mg twice daily, and equally as effective. Three hundred milligrams at night appear to confer protection against the adverse effect of smoking in ulcer healing.

Adolescent↗
PubMed1984

Ranitidine 150 mg twice daily vs 300 mg nightly in treatment of duodenal ulcers.

102 patients with endoscopically proven duodenal ulcers were randomly allocated to treatment with ranitidine either 150 mg twice a day or 300 mg every evening for 4 weeks in a prospective double-blind study. The two groups were similar. 48/57 (84%) healed on ranitidine 150 mg twice daily and 43/45 (96%) healed on 300 mg every evening (p = 0.9)--that is, ranitidine 300 mg as a single night time dose is as effective as 150 mg twice daily. The results also indicate the importance of overnight gastric acidity in the pathogenesis of duodenal ulcers.

Adolescent↗
PubMed1984

Recurrent retching with gastric mucosal prolapse. A proposed prolapse gastropathy syndrome.

A clinical syndrome is described in 22 patients who present with epigastric pain alone or with hematemesis which is associated with a precedent history of recurrent early morning retching or postprandial retching. The characteristic endoscopic finding is a knuckle of inflamed and sometimes bleeding gastric mucosa which repeatedly prolapses into the esophageal lumen during retching. Other upper gastrointestinal lesions are not found. Retching is thought to cause the forceful prolapse and subsequent traumatization of gastric mucosa. The episodes of vigorous retching and resultant gastric trauma are now considered to be the cause of the abdominal pain and hematemesis, and it is proposed that this combination of clinical features illustrates a distinct syndrome which we have called prolapse gastropathy. This condition is a significant cause of hematemesis and abdominal pain in a group of nonalcoholic patients who demonstrate an unusual sensitivity to gag and retch.

Adult↗
PubMed1984

Comparison of ranitidine and cimetidine maintenance treatment of duodenal ulcer.

Sixty-one patients with healed duodenal ulcer were studied during a 12-month maintenance trial with either 150 mg ranitidine at night or 400 mg cimetidine at night. Recurrences were determined at endoscopy after 6 and 12 months of treatment or because of symptomatic relapse. Ulcers recurred in 7 of 28 patients receiving ranitidine and in 8 of 33 patients receiving cimetidine. No serious side effects were encountered.

Adolescent↗
PubMed1983

Postmarketing surveillance of the safety of cimetidine: 12 month mortality report.

A total of 9928 patients taking cimetidine and 9351 controls were recruited to a postmarketing drug surveillance study in Glasgow, Nottingham, Oxford, and Portsmouth. Takers were identified by the Prescription Pricing Bureau at Nottingham and by dispensing pharmacists at the other three centres. All but 1.2% of the takers and 1.6% of the controls were successfully followed up for one year during which hospital visits and deaths were recorded. Three hundred and seventy five of the cimetidine takers and 198 of the controls are known to have died. Most of the difference in mortality was accounted for by an excess among the takers of deaths from cancers of the oesophagus, stomach, colon, and lung; from neoplasms of the lymphatic and haematopoietic system; and from ischaemic heart disease, chronic liver disease, and accidents and poisonings. So far as can be assessed, however, none of these drug-disease associations represented adverse effects of cimetidine treatment; on the contrary, they resulted from cimetidine being used, knowingly or unknowingly, for treating the symptoms of various diseases or for alleviating adverse effects of other agents such as corticosteroids, non-steroidal anti-inflammatory drugs, and radiotherapy. No evidence of any fatal adverse effects of cimetidine emerged in this study.

Aged↗
PubMed1983

Accuracy and value of the Hemoccult test in symptomatic patients.

Hemoccult faecal occult blood testing is widely advocated as a screening test for colorectal cancer but few studies have shown its correlation with conventional methods of investigation for colorectal disease. In a prospective study of 802 symptomatic patients with suspected colorectal disease there was good patient compliance (92.5%) and a high specificity for colorectal cancer (85.4%). The false positive rate was 8.6% (12 of 140 patients with positive results), and while the test result was positive in 22 of 26 colonic cancers the false negative rate for rectal cancer (45.4%) should not detract from its value as a screening test if proper digital anorectal and proctosigmoidoscopic examination are widely practised. A positive Hemoccult test result is a useful indicator for the need to proceed to full colorectal investigation, including colonoscopy.

Adolescent↗