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Biomedical subjects

G R Onstad

Publications and source records attributed to G R Onstad.

At least 37 records · Page 2Linked to original sources

Control of acute gastroduodenal hemorrhage with cimetidine.

Thirty-four patients with acute gastroduodenal hemorrhage were treated with intravenous Cimetidine. Preliminary endoscopy was done at the onset of bleeding to determine the source of bleeding and to rule out the presence of a brisk arterial bleeding site that would require immediate operation for control. Sixteen of the patients had primary peptic ulcer disease and 18 patients had "stress ulcer" syndrome. The bleeding stopped following Cimetidine administration in 14 of the 16 peptic ulcer patients (88%) and in 13 of 18 stress ulcer patients (72%). There was no subsequent rebleeding. The data suggest that Cimetidine is of value in the immediate nonoperative management of acute gastroduodenal hemorrhage. Further, the availability of Cimetidine for postoperative use may modify the surgical approach to stress ulcer bleeding.

Adult↗

The treatment of hemorrhagic gastritis with cimetidine.

Thirteen patients in whom bleeding from hemorrhagic gastritis was not controlled by a variety of therapeutic modalities were treated with cimetidine. Twelve of the 13 patients stopped bleeding. Three subsequently rebled, two of whom required an operation to control the bleeding. The average amount of blood transfused per patient before treatment with cimetidine was 16 units and after cimetidine, 1.6 units. Nine of the 13 patients died, but only one of them died of hemorrhage. The remaining eight patients died of a combination of sepsis and multiple organ failure. We observed no adverse side-effects after the administration of cimetidine. Cimetidine is a safe and reliable means to control bleeding from hemorrhagic gastritis. Once the diagnosis of hemorrhagic gastritis is established, treatment with cimetidine should be begun and continued until the underlying stress which initiated the bleeding is controlled.

Cimetidine↗

Urea synthesis after oral protein ingestion in man.

In an attempt to assess hepatic functional capacity, hourly urea production, and corresponding serum amino acid concentrations after the ingestion of single protein meals (60, 120, and 240 g of protein) were evaluated in 18 normal subjects and in 8 patients with liver disease. In normal subjects, the relationship between urea production and serum amino acid concentration was linear (urea production in milligram urea nitrogen/kilogram lean body mass/hour = 6.3 times mg amino acid nitrogen/100 ml minus 20.5 SE of the estimate 6.9, r = 0.74, P less than 0.001), and variation of protein intake from 50 to 150 g/day for 3 days before testing did not change this relationship. The patients demonstrated impairment of urea synthesis proportional to the clinical severity of their liver disease. The potential clinical applications of these findings need to be determined.

Adult↗