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Biomedical subjects

D K Koblitz

Publications and source records attributed to D K Koblitz.

3 recordsLinked to original sources

[Short-bowel syndrome].

The short bowel syndrome represents the pathophysiological and clinical consequences, following extensive resection or loss of specific function of small intestine, failing adequate comensatory mechanismus. Present therapeutic options allow such patients an acceptable lifestyle. In selected cases, reintroduction into gainful employment becomes feasible. The prolonged adaptive process necessitates interdisciplinary therapeutic efforts, including medical, nutritional, social and psychological approaches. Suitably equipped rehabilitationcentres can successfully handle a considerable proportion of these measures, especially in the framework of an in-patient rehabilitation treatment programme. This article summarizes the physiology, pathophysiology, adaptive mechanisms, clinical picture and presents therapeutic options. In conclusion, sociomedical viewpoints are being discussed.

Aftercare↗

[Treatment of duodenal and prepyloric ulcers with an antacid and cimetidine either alone or in combination].

In an open randomized study the effectiveness and the acceptance of treatment with a cytoprotective antacidum (226 mval acid-neutralisation-capacity per day's dose) have been examined in 60 patients with clinical and endoscopical secured prepyloric and duodenal ulcera compared with Cimetidine (2x 400 mg) and an initial combination in the first week of treatment. The healing rates depend clearly on the size of ulcus at the beginning of treatment. Ulcera smaller than 8 mm heal in 3 1/2 to 4 weeks up to 71% with the Antacidum, up to 56% to 83% with Cimetidine. For larger ulcera the healing rates are clearly poorer (antacida 20%, Cimetidine 33-67%). Initial combination treatment of the antacidum with Cimetidine for 1 week and the further treatment with the antacidum shows a healing rate of 100% for ulcera smaller than 8 mm, for larger ones a rate of 75%. Therefore the initial combination treatment seems to be useful especially for ulcera duodeni and prepyloric ulcera larger than 8 mm.

Adult↗

[1,000 pancreolauryl tests: evaluation of sensitivity, specificity and use in clinical routine].

1115 examinations with the Pancreolauryl-Test (PLT) were carried out and assessed on 918 non-selected patients with various gastro-enterologic diseases. Depending on the severity of the exocrine insufficiency, sensitivity varied in confirmed chronic pancreatitis (n = 54). Overall sensitivity was 69%, in chronic pancreatitis with steatorrhoe 100%, and 54% in moderate insufficiency. In all patients not suffering from pancreatic diseases (n = 789) specificity was 77%. Since the PLT was frequently pathological in patients with subtotal gastrectomy (gastric resection) and active peptic lesion, specificity was also determined excluding these cases (29% of all patients without pancreatic disease). This resulted in a specificity of 86%. Gastric hyperacidity should be taken into consideration as a possible source of errors (for example, in the condition following an ulcer). Age, weight and alcohol consumption as well as diseases of the bile duct and liver, had no influence on specificity. Urine collection errors, occurring in 10% of the patients investigated, could be avoided by determination of fluorescein in the serum. Our results from a series of examinations on non-selected patients with a 6% prevalence of chronic pancreatitis indicated that PLT is likely to increase predictive value in selected application. If the oesophagus-gastro-duodenoscopy is non-pathological but the PLT gives a pathological result, further pancreatic investigative procedures should be carried out.

Adult↗