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Biomedical subjects

H Waldum

Publications and source records attributed to H Waldum.

8 recordsLinked to original sources
PubMed1991

Relationship between endoscopic hiatus hernia and gastroesophageal reflux symptoms.

Little is known about the relationship between hiatus hernia (HH) and gastroesophageal reflux symptoms (GERS). Nine hundred and thirty patients submitted to gastroscopy because of symptoms completed a self-administered questionnaire. Fourteen per cent showed esophagitis (ES) and 17% HH. Forty-nine per cent of the patients with HH had endoscopic ES, and 60% of those with ES had HH. The severity of ES was dependent (p less than 0.05) on both the presence and the size of HH. After exclusion of patients with peptic ulcer and malignancy, patients with and without HH and ES were compared with regard to the presence of single symptoms and a weighted GERS score based on symptoms proven to be typical for ES. Only borderline differences were found between patients with ES and HH and those with ES and no HH. The former group, however, presented with significantly (p less than 0.001) more GERS than the patients with HH only. Nevertheless, the patients with HH as the only pathologic finding had significantly (p less than 0.01) more GERS than the patients with no major endoscopic abnormality. This study indicates a close association between HH and gastroesophageal reflux disease and supports the clinical significance of an endoscopically detected HH.

Adult↗
PubMed1990

The predictive value of history in dyspepsia.

Symptomatic patients referred to an open-access upper gastrointestinal endoscopy completed a detailed, self-administered questionnaire aimed at assessing the predictive value of history in dyspepsia. Nine hundred and thirty patients were suitable for analysis. Of these, 29% were found to have organic dyspepsia. A substantial overlap of symptoms and demographic data was found among the various endoscopic diagnoses. Discriminating variables were identified by stepwise logistic regression analysis and included in predictive score models. Pain relieved by antacids, age above 40 years, previous peptic ulcer disease, male sex, symptoms provoked by berries, and night pain relieved by antacids and food were found to predict organic dyspepsia with a sensitivity and specificity of approximately 70%, when applied on the observed material. Similar probabilities were found for score models of peptic ulcer and esophagitis. In general, the low prevalence of organic diseases resulted in low positive and high negative predictive values. Accordingly, the main impact of the predictive models may be to reduce the number of negative endoscopies rather than to predict a precise diagnosis. Independent of disease category and age, 41% of the subjects expressed a fear of malignancy, emphasizing the value of reassurance from a negative endoscopy.

Adult↗
PubMed1986

The clinical benefit of routine upper gastrointestinal endoscopy.

In a prospective study including 1526 consecutive endoscopies, attempts were made to characterize the benefit of upper gastrointestinal endoscopy. Before endoscopy judgements were made about the most likely diagnosis and treatment and about the degree of suspicion of upper gastrointestinal malignancy. After endoscopy the same types of judgement were made again. The study showed that about half of the endoscopies disclosed clinically significant abnormalities. Furthermore, about every third endoscopy led to unpredicted diagnostic and diagnostic and therapeutic consequences. The benefit was comparably small in patients below the age of 40 years and particularly great in patients above the age of 65, in patients submitted to endoscopy because of barium meal pathology or general suspicion of malignancy, and in patients with upper gastrointestinal bleeding. In general, the present study supports the widespread use of upper gastrointestinal endoscopy in clinical practice.

Adolescent↗
PubMed1985

Gastric acid and pepsin secretion in response to modified sham feeding in active and inactive duodenal ulcer disease.

Gastric secretion of acid and pepsin were studied under basal conditions, in response to modified sham feeding (MSF), and in response to pentagastrin in 15 male controls and in 11 and 10 male patients with active and inactive duodenal ulcer disease, respectively. In general, patients with ulcer disease produced more acid and pepsin than controls. No differences between the two ulcer groups were found for basal and pentagastrin-stimulated secretions. The response patterns to MSF, however, were different in the two groups. After an early peak, acid and pepsin responses rapidly decreased, approaching basal level in patients with active duodenal ulcer and in controls. In patients with inactive disease, however, the decrease was less marked, and in some patients the secretion continued to increase for 60 min. When expressed as fractions of the responses to pentagastrin, the acid and pepsin responses during the fourth 15-min period were significantly greater in patients with inactive duodenal ulcer disease than in patients with active disease and in controls. The findings indicate that the gastric response to vagal stimulation is different in patients with active and inactive duodenal ulcer disease.

Adult↗
PubMed1979

Acute cochleovestibular dysfunction.

A case of acute vertigo and sudden deafness with concomitant eye lesions is presented. The possible differential diagnoses are discussed, and the principles of treatment outlined.

Acute Disease↗