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Biomedical subjects

H Glise

Publications and source records attributed to H Glise.

At least 19 recordsLinked to original sources
PubMed1998

Does endoscopy have a positive impact on quality of life in dyspepsia?

BACKGROUND: It is unclear whether normal endoscopy results in patients investigated for dyspepsia has therapeutic value. Therefore the aim of this study was to evaluate the effect of the endoscopy on quality of life and dyspeptic symptoms. METHODS: One hundred ninety-six symptomatic patients (85 men and 111 women, mean age 42.9 years), who were receiving no treatment, were investigated before and 1 week after endoscopy with the use of a battery of validated questionnaires. RESULTS: Before endoscopy the health-related quality of life was compromised in comparison with a normal population, but 1 week after a negative endoscopy it is increased to a level which was close to the normal range despite no major change in symptoms. Physical activity and sleep scores improved significantly after endoscopy. CONCLUSION: The present results suggest that a negative endoscopy improves quality of life in the short-term in patients with dyspepsia, even though symptoms may persist.

Abdominal Pain↗
PubMed1997

Heartburn without oesophagitis: efficacy of omeprazole therapy and features determining therapeutic response.

BACKGROUND: Data are limited on the value of effective antisecretory therapy in the relief of heartburn in patients without oesophagitis. METHODS: Patients with heartburn, without endoscopic signs of oesophagitis, were randomized to double-blind treatment with omeprazole, 20 or 10 mg once daily, or placebo, for 4 weeks (n = 509). Pre-treatment oesophageal acid exposure was assessed using 24-h intra-oesophageal pH monitoring. Heartburn was assessed at 2 and 4 weeks. RESULTS: At 4 weeks the proportion of patients with complete absence of heartburn was 46% (95% confidence interval, 39-53%) with 20 mg omeprazole, 31% (25-38%) with 10 mg omeprazole, and 13% (7-20%) with placebo. Satisfaction with therapy was reported by 66%, 57%, and 31% of the patients, respectively. CONCLUSION: Omeprazole, 20 and 10 mg once daily, provides rapid relief of heartburn in patients without endoscopic oesophagitis.

Anti-Ulcer Agents↗
PubMed1997

Preoperative local infiltration with ropivacaine for postoperative pain relief after inguinal hernia repair. A randomised controlled trial.

OBJECTIVE: To assess the effect of preoperative local anaesthesia with ropivacaine and find out if there was a dose-response relationship with postoperative pain after inguinal hernia repair. DESIGN: Randomised, double-blind, placebo-controlled trial. SETTING: Two Swedish and two Norwegian hospitals. SUBJECTS: 131 Male patients undergoing elective inguinal hernia repair. INTERVENTION: Infiltration of the inguinal field before operation with 0.5% ropivacaine 40 ml (200 mg), 0.25% ropivacaine 40 ml (100 mg) or saline 40 ml. MAIN OUTCOME MEASURES: Wound pain at rest and during mobilisation, pressure exerted to reach pain threshold and maximum pain tolerance after 3, 6, 10, and 24 hours, and after 7 days; consumption of analgesics; and Quality of Life assessed by two independent questionnaires before and after operation. RESULTS: Pain scores after 3 hours were significantly lower in the ropivacaine groups compared with the saline group for all variables (p < 0.05). At 6 hours pain scores were significantly lower for ropivacaine 0.5% compared with saline for wound pain during mobilisation and pressure exerted to reach maximum pain tolerance. Patients given saline made their first request for analgesics significantly sooner than in the other two groups (p < 0.05), and a significantly larger percentage of them requested analgesics during the first 24 hours (p < 0.05). Evaluation of the Quality of Life questionnaires showed no significant differences between the groups. CONCLUSION: Ropivacaine has a significant, dose-related pain-reducing effect in the immediate postoperative period but we could find no support for the theory that preoperative infiltration analgesia reduces long term pain.

Adolescent↗
PubMed1996

Laparoscopic suture closure of perforated peptic ulcer. A nonrandomized comparison with open surgery.

BACKGROUND: Laparoscopic vs open suture in the surgical treatment of perforated peptic ulcer were compared in a retrospective study. METHODS: The outcome of 10 patients having the laparoscopic procedure was compared with the outcome of 17 patients treated with suture via laparotomy during the same time period. RESULTS: The mortality rate and the complication rate were comparable. The laparoscopic procedure was more time consuming; hospital stay did not differ. CONCLUSIONS: The results indicate that surgery for perforated peptic ulcer can be performed with the laparoscopic technique with an outcome comparable to open surgery. No obvious advantages to the patient were noted with the laparoscopic method.

Aged↗
PubMed1996

Pathophysiology in gastroesophageal reflux disease: the surgeon's view.

Symptoms of gastroesophageal reflux are common in the general population. Pathophysiological factors of importance include esophageal and gastric motility, hiatal hernia, acid secretion as well as anatomical and hormonal factors. In the eye of the surgeon several of the most important factors for severe reflux can be corrected surgically. These include lower esophageal sphincter pressure, esophageal intra-abdominal length and hiatal hernia. The result of surgery is dependent on whether the patient has symptoms related to gastroesophageal reflux or not. It is important that disease history symptoms and pathophysiological findings at investigations match. We have found that not all physiological investigations have to be pathological. Symptomatic response to profound acid inhibition is essential, however, and patients not responding to a high dosage of proton-pump inhibitors should be reconsidered.

Fundoplication↗
PubMed1996

Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease.

This article presents the relevance of norm values to a battery of Quality of Life questionnaires for use in upper gastrointestinal disorders. The derivation of reference values offers an important contribution by confirming the ability of the questionnaires to differentiate patients from healthy controls. Two self-administered questionnaires, the Psychological General Well-being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS) were used. The norm values were derived in a randomly selected sample from a Swedish population consisting of 4624 individuals (reference group). The patients comprised more than 900 patients with gastroesophageal reflux disease (GORD) included in clinical trials. In the reference group, males reported significantly higher values on well-being as compared with women, whereas women reported more pronounced gastrointestinal symptoms than men. Generally, the younger persons and the group aged 60-70 years reported the highest well-being. Among gastrointestinal patients women scored lower and reported more symptoms than men. With increasing age, well-being improved and symptoms declined. Even though the well-being and symptoms scores differed between patient and the reference group similar patterns in terms of age and gender were observed. In summary, the results show that there are differences with respect to gender and age among normal controls as well as in GORD patients. These aspects have to be considered in clinical studies. The results also support the discriminative ability of the Quality of Life instruments.

Adult↗
PubMed1996

Quality of life: a reflection of symptoms and concerns.

BACKGROUND: Upper gastrointestinal complaints are common in the general population. Most patients consulting have no or only minimal markers of disease. It is important to evaluate new methods for the assessment and follow-up of treatment of these new patient groups. METHODS AND RESULTS: Recent publications on Quality of Life (QOL) and upper gastrointestinal disease are reviewed with the specific aim of relating the effect of disease symptoms and patient concerns to the outcome of investigations. We found that QOL is adversely affected in upper gastrointestinal disorders and that effective treatment medically or surgically normalizes the scores. There is a good correlation between degree of symptoms and QOL outcome. Patients' concern affects the outcome. CONCLUSION: QOL assessments are helpful in evaluating the impact of upper gastrointestinal disease.

Gastrointestinal Diseases↗
PubMed1995

Quality-of-life assessments in evaluation of laparoscopic Rosetti fundoplication.

UNLABELLED: It has recently been suggested that quality-of-life investigations should be included in the evaluation of new medical and surgical regimens. We present the quality-of-life evaluations for the first 40 consecutive patients undergoing laparoscopic antireflux surgery at our department. Two well-established and validated questionnaires, the Psychological General Well Being (PGWB) Index, and the Gastrointestinal Symptom Rating Scale (GSRS), were used. The PGWB gives a general measure of patients' well-being while the GSRS concentrates on gastrointestinal complaints. In untreated reflux esophagitis patients, the PGWB score is very low. We found normal PBWB scores preoperatively during optimal medical treatment with potent acid inhibition. The average score became significantly better (than on medical treatment, P < 0.05) 1 month postoperatively, after which it fell off to normal values 3 and 8-12 months after operation. The GSRS scores were good in all subgroups postoperatively, especially regarding reflux syndrome, where scores were significantly (P < 0.05) better than on medical treatment. IN CONCLUSION: After laparoscopic antireflux surgery, patients had good quality-of-life scores, better than untreated patients and as good as or better than on optimal medical treatment. Different treatment regimens could be discriminated by adding the patients' view of the treatment effect. We suggest that quality-of-life effects should be included when evaluating new regimens in laparoscopic surgery.

Esophagitis, Peptic↗
PubMed1995

Thoracic herniation and intrathoracic gastric perforation after laparoscopic fundoplication.

This case report describes a serious complication after laparoscopic Rosetti fundoplication. Two days postoperatively the proximal part of the stomach herniated into the thoracic cavity where a gastric perforation caused leakage. The patient was reoperated and a new fundoplication was constructed. Postoperatively the patient recovered. Possible mechanisms are discussed.

Female↗
PubMed1995

Quality of life and cost of therapy in reflux disease.

UNLABELLED: BACKGROUND AND RESULTS IN THE LITERATURE: Reflux symptoms are common, with an incidence of up to 40% monthly and 7% daily in the general adult population. The duration of symptoms in patients seeking help for reflux is often in excess of 5 years in an unselected population. A majority, 70%, of those with daily symptoms do not have esophagitis at endoscopy but still require regular medication for symptom control. After treatment, relapse is seen in a majority of cases in whom esophagitis is present at start of therapy. Symptoms of reflux and upper abdominal dyspepsia affect several aspects of daily living. Consequently quality of life (QoL) is low in patients with reflux esophagitis and upper dyspepsia. Values normalize during medical treatment or after surgery for reflux esophagitis. Cost of treatment is complex. Evaluations in patients with reflux esophagitis are based on the effectiveness and cost of the drug, the cost of investigations and time lost from work. In comparisons based on the results of clinical healing trials, omeprazole has been found the most cost-effective drug for treatment of reflux esophagitis. There are as yet no evaluations made for patients with reflux symptoms only. CONCLUSIONS: The consequences for the patient and society regarding QoL and costs for reflux symptoms should be evaluated more closely to optimize future therapy.

Adult↗
PubMed1995

The effect of cisapride and ranitidine as monotherapies and in combination in the treatment of uncomplicated gastric ulceration.

BACKGROUND: Stimulation of gastric motility has been supposed to accelerate the healing of gastric ulcer. The combination of the prokinetic drug cisapride and the H2 blocker ranitidine was tested in the treatment of uncomplicated gastric ulcer. METHODS: Cisapride, 20 mg twice daily (Cis), and ranitidine, 150 mg twice daily (Ran), were given as monotherapies and in the combination 20 mg cisapride and 150 mg ranitidine daily (Cis + Ran) for a maximum of 8 weeks. The study was multicentre, randomized, and double-blind. RESULTS: A total of 197 patients were included. Healing rates in the per-protocol analysis after 4 and 8 weeks' treatment were 61%/84%, 52%/69%, and 61%/92% for the Cis + Ran (n = 56), Cis (n = 58), and Ran (n = 59) treatment groups. No statistically significant difference in healing rates was seen when comparing Cis + Ran with the monotherapies. Symptom relief at the end of treatment was significantly better in the Ran group than in the Cis + Ran group with regard to epigastric pain (p = 0.01) and vomiting (p = 0.05). Patients' global evaluation of treatment was in favour of Ran in comparison with Cis + Ran treatment (p = 0.04). CONCLUSIONS: Combination of cisapride and ranitidine in the treatment of gastric ulcer did not enhance the healing rate or improve symptom relief in patients treated for uncomplicated gastric ulcer when compared with the monotherapies.

Anti-Ulcer Agents↗
PubMed1995

Well-being and gastrointestinal symptoms among patients referred to endoscopy owing to suspected duodenal ulcer.

BACKGROUND: Few studies have evaluated quality of of life (QoL) in patients with upper gastrointestinal diseases, and there is a lack of validated measures for use in gastroenterology. METHODS: The applicability and relevance of self-administered questionnaires such as the Psychological General Well-Being (PGWB) index and the Gastrointestinal Symptoms referred to endoscopy because of suspected duodenal ulcer were evaluated. RESULTS: In total, 1526 patients with suspected duodenal ulcer were screened for inclusion in a clinical study. On the basis of medical history and endoscopy, 1424 patients who completed the questionnaire before endoscopy were classified in five diagnostic groups: oesophagitis, gastric ulcer, duodenal ulcer, negative endoscopy, and gastritis duodenitis. Irrespective of diagnosis, all patient groups reported a considerable decrease in their general well-being (mean score, 85, compared with 105 in healthy populations) with no significant differences between the groups. The results of the GSRS, however, showed statistically significant differences between the groups in dimensions depicting Abdominal pain, Reflux, Indigestion, and Diarrhoea Syndrome. CONCLUSIONS: The results of the study showed that, irrespective of endoscopic findings, patients complaining of upper gastrointestinal symptoms have a low degree of general well-being. The symptoms profiles in the different diagnostic groups vary considerably.

Duodenal Ulcer↗
PubMed1995

Laparoscopic Rosetti fundoplication.

BACKGROUND: Early experiences with laparoscopic fundoplication using the Rosetti technique are presented and compared with retrospective results from conventional fundoplication procedures. METHODS AND RESULTS: We have performed 70 consecutive laparoscopic procedures. Conversion to open surgery was done in seven cases because of anatomical reasons and in two because of peroperative progressive subcutaneous emphysema and CO2-retention. The complication rate was low. The range of postoperative hospital stay is 1-4 days for non-converted patients. Symptomatic follow-up has hitherto been performed in 41 patients with a follow-up time of 3-9 months. The follow-up results do not differ from those achieved in patients operated upon with the conventional open Nissen (n = 41) and Rosetti (n = 36) techniques. Pre- and postoperative control of 24 h pH and lower esophageal sphincter pressure (LESP) in 19 laparoscopically treated patients showed normalization of LESP in all cases and postoperative 24 h pH < 4 ranging between 0 and 3%. CONCLUSIONS: Laparoscopic and reflux surgery is effective for the treatment of reflux esophagitis. Follow-up results compare well with open surgery.

Adolescent↗
PubMed1995

Quality of Life assessments in the evaluation of gastroesophageal reflux and peptic ulcer disease before, during and after treatment.

BACKGROUND: It has recently been suggested that Quality of Life (QOL) be used in the evaluation of new medical treatment regimens together with cost-benefit, efficacy and safety. In this overview we point out some aspects of use of the Psychological General Well-Being Index (PGWB) in patients with peptic ulcer and reflux disease gained from our own investigations in later years. METHODS: QOL was assessed using questionnaires before diagnosis, during medical healing treatment and at a 1-year follow-up in peptic ulcer disease or before and after surgery in reflux disease. RESULTS: Untreated patients with unknown diagnosis had low QOL scores. With treatment, scores increased rapidly to supernormal values and fell off to normal values during the follow-up year. CONCLUSION: QOL evaluations seem sensitive and reflect the patient's subjective feeling of disease. They add another new aspect of treatment effect not earlier included in treatment evaluations.

Female↗
PubMed1994

Laparoscopic Rosetti fundoplication.

Early experiences with laparoscopic fundoplication using the Rosetti technique are presented and compared with retrospective results from conventional fundoplication procedures. A 360 degrees floppy fundoplication was laparoscopically constructed without division of short gastric vessels. We have performed 60 consecutive procedures. Conversion to open surgery was done in seven cases due to anatomical reasons and in two due to progressive subcutaneous emphysema and CO2-retention. The complication rate was low. The range of postoperative hospital stay is 1-4 days for non-converted patients. Symptomatic follow up has hitherto been performed in 41 patients with a follow-up time of 3-9 months. Regurgitation and heartburn had disappeared in all but one patient. The follow-up results do not differ from those achieved in patients operated upon with the conventional open Nissen (N = 41), Toupét (N = 9) or Rosetti (N = 36) technique. Pre and postoperative control of 24h pH and lower esophageal sphincter pressure (LESP) in 19 laparoscopically treated patients showed normalisation of LESP in all cases and postoperative 24h pH < 4 ranging between 0 and 3%. Assessment of quality of life showed postoperative results in accordance with normal population for all treated groups.

Esophagogastric Junction↗