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Biomedical subjects

L R Celestin

Publications and source records attributed to L R Celestin.

At least 19 recordsLinked to original sources
PubMed1995

Eradication of Helicobacter pylori and prevention of recurrence of duodenal ulcer: a randomized, double-blind, multi-centre trial of omeprazole with or without clarithromycin.

BACKGROUND: Antimicrobial treatment for Helicobacter pylori eradication is currently recommended for all patients with duodenal ulcer disease, but consensus on the best treatment is lacking. METHODS: Patients with active duodenal ulcer and H. pylori were enrolled in a double-blind, randomized, placebo-controlled multi-centre study. Patients received omeprazole 40 mg daily for 28 days and either clarithromycin 500 mg t.d.s. or placebo t.d.s. for the first 14 days. Patients underwent endoscopy before starting treatment, at 2 weeks, immediately after stopping treatment if unhealed at 2 weeks, and at 1, 6 and 12 months after the end of treatment, or at the recurrence of symptoms. Eradication of H. pylori, duodenal ulcer healing and ulcer recurrence were measured. RESULTS: One-hundred and fifty-four patients were recruited and randomized to omeprazole plus clarithromycin (n = 74) or to omeprazole plus placebo (n = 80). One month after treatment, H. pylori was eradicated in 57 of 69 (83%; 95% CI: 72-91%) patients receiving omeprazole plus clarithromycin, compared with 1 of 75 (1%; 95% CI: 0-7%) receiving omeprazole alone (P < 0.001). In patients receiving omeprazole plus clarithromycin the ulcer healed at 2 weeks in 83% (95% CI: 71-91%) and at 4 weeks in 100% (95% CI: 95-100%), compared with 77% (95% CI: 66-86%) and 97% (95% CI: 91-100%) in those given omeprazole plus placebo (N.S.). Ulcers recurred at 12 months in 6% (95% CI: 1-16%) of patients given omeprazole plus clarithromycin, compared with 76% (95% CI: 63-86%) of patients given omeprazole plus placebo (P < 0.001). The incidence of side-effects was similar in both treatment groups (38% with clarithromycin dual therapy and 29% with omeprazole plus placebo; P = 0.304). Ninety per cent of patients took at least 90% of their prescribed medication. CONCLUSIONS: Omeprazole plus clarithromycin dual therapy eradicated H. pylori in 83% of patients with duodenal ulcer and significantly decreased 12-month recurrence from 76% to 6%.

Adult↗
PubMed1985

Large gallstones may pass spontaneously.

We report two cases in which gallstones greater than 1 cm in diameter passed spontaneously from the common bile duct into the duodenum. The possibility of spontaneous passage should be borne in mind in the management of patients with common duct stones.

Common Bile Duct↗
PubMed1983

Specific vagotomy.

Explore the source record for details and available documents.

Duodenal Ulcer↗
PubMed1983

Glucose and insulin levels in duodenal ulcer disease before and after surgery.

Glucose and insulin responses to a standardized test meal in patients with chronic duodenal ulceration were measured pre-operatively and again post-operatively. An abnormal pre-operative glucose tolerance contributes to an even more deranged post-operative glucose tolerance. However, following administration of an alpha-glucosidase inhibitor, Acarbose, these post-operative abnormalities are markedly attenuated.

Acarbose↗
PubMed1979

Anorectal Crohn's disease.

Four hundred and twenty-three patients with Crohn's disease have been reviewed, 48 of whom had isolated anorectal involvement--an incidence of 11.4 per cent. These patients were compared with 48 randomly selected and sex-matched cases who presented with isolated ileocolic disease. The age of the anorectal patients (53.6 +/- 18 years) was greater than that of the controls (34.2 +/- 12 years). The duration of follow-up was 6.0 +/- 4 years and 12.6 +/- 8 years respectively. Rectal bleeding, diarrhoea and perianal disease were more common in the anorectal group. Twenty-two patients (46 per cent) with anorectal disease and 40 (83 per cent) in the ileocolic group underwent definitive surgery. There were 4 (18 per cent) postoperative deaths in the anorectal group and none among the controls. The incidence of recurrence was lower among the anorectal patients (21 per cent) compared with the ileocolic group (40 per cent). However, the estimated probability of recurrence, based on the duration of follow-up, the number of deaths during follow-up and the actual incidence of recurrence, is similar in both groups.

Adolescent↗