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Biomedical subjects

E J Boyd

Publications and source records attributed to E J Boyd.

At least 55 records · Page 3Linked to original sources
PubMed1984

Safety of ranitidine maintenance treatment of duodenal ulcer.

During maintenance treatment with nocturnal ranitidine (150 mg) for 1 year, 38% of duodenal ulcers relapsed. Twenty-one patients whose ulcers remained healed after maintenance treatment for 1 year continued to receive ranitidine (150 mg at night) for a further year, while 26 patients with healed ulcers received placebo in a randomized double-blind study. The rate of recurrence of duodenal ulcers during the 2nd year of follow-up study was 18% in ranitidine-treated individuals and 87% in those receiving placebo. The ulcer recurrences of patients receiving ranitidine tended to be asymptomatic and were clinically mild in the rest. Recurrences in patients receiving placebo were usually symptomatic and significantly more likely to be associated with bleeding. We conclude that ulcers that remain healed after 1 year's maintenance treatment with ranitidine tend to remain healed if maintenance treatment is continued. Moreover, this type of continuous treatment of duodenal ulcer is clinically safer than no treatment of the ulcer disease.

Clinical Trials as Topic↗
PubMed1983

Smoking impairs therapeutic gastric inhibition.

Cigarette smoking reversed the inhibition of nocturnal gastric secretion produced by the H2-receptor antagonists cimetidine and ranitidine and by the phenothiazine derivative LM 24056. As a consequence of smoking, nocturnal secretion of acid increased by 91.5% and of pepsin by an average of 59% when compared with control studies when patients did not smoke. The inhibition of pentagastrin-stimulated gastric secretion produced by cimetidine or poldine was not affected by cigarette smoking. Since control of nocturnal secretion may be important in promoting ulcer healing and maintenance of remission, patients receiving antisecretory drugs should be advised not to smoke after having taken their nocturnal dose of the drug.

Adult↗
PubMed1983

Review of ulcer treatment: role of ranitidine.

Ranitidine, given twice daily, increases the rate of healing of duodenal and gastric ulcers, irrespective of geographical location. The majority of ulcers (90-100%) heal after 2 months of treatment. Ulcers resistant to ranitidine treatment are uncommon and ranitidine heals ulcers resistant to other drugs, e.g. cimetidine. Healing of ulcers has been accompanied by an insignificant number of mild and reversible side effects. However, about 80% of healed ulcers recur within 1-2 years of stopping treatment. Continued treatment, with nocturnal administration of one half the healing dose of ranitidine, reduces the rate of recurrence during the first 12 months after healing to about 30% for duodenal ulcers and 20% for gastric ulcers. There is considerable variation within and between different countries. The recurrent ulcers seem to be clinically less severe than recurrences without maintenance treatment and are easily rehealed. If remission is maintained for more than 12 months during continued therapy, recurrence is uncommon. No significant adverse effects have been observed during maintenance treatment lasting nearly 3 years. The mechanisms whereby ranitidine heals ulcers and maintains remission are undefined but some possible processes are discussed.

Cimetidine↗
PubMed1983

Inhibition of pentagastrin-stimulated and overnight gastric secretion by mianserin.

1 The effects of mianserin (60 mg) have been studied on nocturnal and pentagastrin-stimulated gastric secretion. 2 Mianserin reduced pentagastrin-stimulated gastric acid secretion by 38%, pepsin by 40% and secretory volume by 45% during a 1 h test. 3 Twelve-hour overnight secretion of acid was reduced by 37%, while secretion of pepsin was reduced by 43% and secretory volume by 51%. 4 No adverse effects were noted. 5 These findings, which achieve statistical significance, suggest the need for further study to evaluate the possible role of mianserin in the therapy of duodenal ulcer disease.

Dibenzazepines↗
PubMed1983

Effects of treatment compliance and overnight gastric secretion on outcome of maintenance therapy of duodenal ulcer with ranitidine.

Eighty-seven patients with endoscopically healed duodenal ulcers received continuous maintenance treatment with a standard dose of 150 mg ranitidine at night for 6-12 months. The cumulative annual rate of symptomatic reulceration was 24%, whereas a further 25% of asymptomatic relapses were detected with routine endoscopic examination. Compliance with drug therapy was assessed by urinalysis for ranitidine and by returned tablet count. Urinalysis appeared to provide the more accurate index of drug intake. Compliance was similar in patients whose ulcers remained healed after 1 year's treatment and in patients with asymptomatic recurrence. Patients who developed symptomatic recurrences showed significantly poorer compliance in the period before development of symptoms. Overnight secretion of acid and pepsin during treatment did not differ between patients whose ulcers remained healed and those with relapses. Poor compliance was not implicated in the development of recurrence in patients who had good inhibition of overnight gastric secretion. We conclude that duodenal ulceration can recur during nocturnal maintenance treatment despite good compliance and satisfactory inhibition of nocturnal gastric secretion. However, symptomatic manifestation of the recurrences reflects poor compliance with treatment.

Duodenal Ulcer↗
PubMed1982

Late presentation of Shwachman's syndrome.

Shwachman's syndrome is a rare cause of pancreatic exocrine insufficiency in childhood. It is usually associated with poor growth, neutropaenia and dyschondroplasia of bone metaphyses. Numerous associated congenital abnormalities and hereditary conditions have been described. The vast majority of cases are diagnosed before the age of two. The case described is of a girl presenting with steatorrhoea at age fourteen. Although of small stature, she had been completely well until that time. While survival of infantile cases into adolescence is reported, presentation of the condition in later years is rare and Shwachman's syndrome should therefore be considered as a possible cause of pancreatic insufficiency in older children and adolescents.

Adolescent↗
PubMed1982

Mitogen stimulation of peripheral blood lymphocytes of duodenal ulcer patients during treatment with cimetidine or ranitidine.

During a double-blind randomised clinical trial of cimetidine and ranitidine in the management of duodenal ulcer, the response of patients' peripheral blood lymphocytes to optimal mitogenic stimulation in vitro has been measured. Treatment with cimetidine, but not ranitidine, was associated with a significant increase in the proportion of peripheral blood lymphocytes responding to this optimal mitogenic stimulation. We conclude that these effects of cimetidine may not be mediated at classical histamine H2-receptors.

Adult↗
PubMed1982

Prospective comparison of the fluorescein-dilaurate test with the secretin-cholecystokinin test for pancreatic exocrine function.

In a prospective study of 60 patients undergoing investigation for possible exocrine pancreatic disease the fluorescein-dilaurate test was compared with the secretin-cholecystokinin (CCK) test. Forty one patients had a normal response to secretin-CCK, 14 patients had abnormal responses and in five patients the results were equivocal. Taking the secretin-CCK test as the diagnostic criterion, the fluorescein-dilaurate test had a sensitivity of 100% and a negative predictive value of 100%. There was a 54% false-positive rate. The fluorescein-dilaurate test is easy to perform and is a useful screening test for pancreatic exocrine insufficiency.

Adolescent↗
PubMed1982

Pancreatic synthetic rates: a new test of pancreatic function.

Synthesis of pancreatic enzymes was measured in 7 patients with chronic pancreatitis and 10 patients with no pancreatic disease, on the basis of the incorporation of 75Se-methionine into pancreatic exocrine proteins. Two of the patients with chronic pancreatitis had normal exocrine function. Pancreatic secretion was stimulated by intravenous infusion of secretin (1 clinical unit x kg-1 x h-1) and cholecystokinin (1 Ivy dog unit x kg-1 x h-1). 75Se-methionine (3.0 microCi x kg-1) was added to the infusion. Synthetic rates were significantly greater in all the patients with chronic pancreatitis, including the two individuals with normal responses to stimulation with secretin and cholecystokinin. Studies of synthetic rates may therefore be able to confirm the diagnosis of chronic pancreatitis before exocrine insufficiency becomes manifest.

Adolescent↗
PubMed1982

The effects of impromidine and pentagastrin on gastric output of histamine, acid and pepsin in man.

Histamine and hydrogen ion concentrations and peptic activity have been measured in gastric juice in 8 normal subjects during infusion of pentagastrin, pentagastrin plus cimetidine, and impromidine. The stimulation of gastric secretion under all 3 conditions produced an initial increase in histamine concentration and output in gastric juice, which was not sustained. The total stimulated histamine output in one hour was similar with pentagastrin and pentagastrin plus cimetidine, but was significantly higher with impromidine (p less than 0.05), a histamine methyltransferase in normal human gastric mucosa. These results do not support the concept that histamine is the final local common chemostimulator of the parietal cell in man.

Adult↗
PubMed1981

Inhibition of pentagastrin-stimulated and overnight gastric secretion by LM24056, a new phenothiazine-derived antisecretory drug.

LM24056, a tricyclic drug, weakly inhibited pentagastrin-stimulated gastric secretion but was a powerful inhibitor of nocturnal gastric secretion in 5 healthy volunteers. In 23 patients with duodenal ulcer, LM24056 at doses of 100,200, and 300 mg inhibited overnight acid output by 31%, 70%, and 81%, and overnight pepsin secretion by 15%, 50%, and 69%, respectively. In view of its gastric inhibitory effects, LM24056 warrants clinical evaluation in the treatment of peptic ulcer disease.

Anti-Ulcer Agents↗
PubMed1981

Effects of two histamine H2-receptor blocking drugs on basal levels of gonadotrophins, prolactin, testosterone and oestradiol-17 beta during treatment of duodenal ulcer in male patients.

In a study of 51 male patients with duodenal ulcer, treatment with cimetidine was accompanied by an increase in basal levels of serum testosterone. Treatment with ranitidine, a new histamine H2-receptor antagonist, produced no such effect. It is concluded that cimetidine had antiandrogenic activity in man which is separate from the histamine H2-receptor blocking activity.

Adult↗
PubMed1981

Ranitidine in the treatment of duodenal ulceration.

In a randomized, double-blind, endoscopically controlled clinical trial, 40 patients with duodenal ulcer were treated with either ranitidine (320 mg/day) or cimetidine (800 mg/day) for 28 days. The rate of healing of the ulcers (ranitidine, 78%, cimetidine, 45%) did not differ significantly in the two treatment groups. In a subsequent 'open' study, ranitidine (150 mg twice daily) healed the ulcers of 79% of 19 patients treated for 28 days. Treatment with ranitidine was not associated with significant adverse reactions and had no lasting effect on gastric secretory capacity. Whereas basal levels of serum testosterone rose significantly during treatment with cimetidine, no such increase was observed during treatment with ranitidine. We conclude that ranitidine can effectively and safely heal duodenal ulcers.

Adult↗
PubMed1981

Clinical and endocrine aspects of treatment with ranitidine.

Ranitidine has been shown to heal the majority of duodenal ulcers during treatment with 300 or 320 mg daily for 4 to 8 weeks. Twice-daily dosage improved compliance. Subsequent maintenance treatment with ranitidinie, 150 mg at night prevented relapse in the majority of patients during 6-months' follow-up. Ranitidine did not appear to have any anti-androgenic effects.

Administration, Oral↗