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Biomedical subjects

M Schlup

Publications and source records attributed to M Schlup.

15 recordsLinked to original sources
PubMed1999

Omeprazole therapy decreases the need for dilatation of peptic oesophageal strictures.

BACKGROUND: Better control of gastric acid secretion with omeprazole appeared to decrease the need for dilatation of oesophageal strictures complicating gastro-oesophageal reflux disease in our hospital-based endoscopy service. AIM: To investigate whether the perceived decrease in the need for oesophageal dilatation could be documented from endoscopy records, and, if confirmed, whether this could be related to the treatment used. PATIENTS AND METHODS: Retrospective study of the records of 69 patients who had peptic oesophageal strictures dilated, followed by treatment with acid inhibition for at least 6 months. Mean duration of follow-up was 3.9 years during treatment with H2-receptor antagonists and 2.1 years while on omeprazole (258 and 78 patient-years, respectively). Re-dilatation rates were compared between those treated with H2-receptor antagonists or omeprazole. RESULTS: There has been a significant decrease in dilatations performed for gastro-oesophageal reflux induced strictures (P<0.001), while dilatation rates for other indications remained constant. Treatment with omeprazole not only decreased the need for further dilatations, but also prolonged the mean time between any further dilatations to 26.3 months compared to 9.3 months for those on an H2-receptor antagonist (P<0.0001). CONCLUSIONS: Following dilatation of peptic oesophageal strictures, treatment with omeprazole in place of an H2-blocker significantly decreases the need for repeat dilatation.

Adult↗
PubMed1993

Potential of measurements of unsaturated vitamin B12-binding capacity in serial colonoscopic biopsy specimens for global and regional assessments of disease severity in inflammatory bowel disease.

We investigated whether measurements of unsaturated vitamin B12-binding capacity (UBBC), in homogenates of serial colonoscopic biopsy specimens, could be used as objective measures of disease severity in ulcerative colitis (UC) and Crohn's disease (CD). On a regional basis UBBC activity correlated with and showed good agreement with endoscopic and histologic activity scores (r = 0.8 and 0.6, respectively, for UC, and r = 0.7 and 0.7, respectively, for CD). For global assessment aggregate UBBC, endoscopic and histologic scores were compared with standard clinical activity scores. In UC, correlations with the van Hees index were r = 0.7, 0.8, and 0.7, respectively, and UBBC assays accurately reflected both regional and global disease activity. In CD, correlations with the CDAI were -0.1, 0.7, and 0.6, respectively. Thus, aggregate UBBC scores failed to reflect disease activity in CD, in which focal deep ulcers may produce high symptom scores but in which adjacent specimens may show no acute inflammation.

Biomarkers↗
PubMed1990

Evaluation of a new fine needle technique in routine percutaneous liver biopsy.

A new fine needle aspiration biopsy technique (Vacu-Cut, 19.5 G) was compared to the 17 G Menghini needle in 20 consecutive patients scheduled for routine percutaneous liver biopsy (10 at random with each needle). The Menghini system was superior in producing sufficient material for histological assessment with 90% success on first pass biopsy (100% with 12 passes in 11 patients) as compared to 60% with the Vacu-Cut needle (90% with 16 passes in 10 patients). The latter was easier to use. Ability to reach a histological diagnosis was 100% with both needles. No major complications occurred: only one Vacu-Cut patient (10%) developed pain at the puncture site as compared to seven patients (65%) in the Menghini group, irrespective of number of passes. The ease of use and lower incidence of pain may favour the Vacu-Cut needle in selected ill patients.

Adult↗
PubMed1986

Crohn's disease: a ten year retrospective review at Dunedin hospitals.

Based on strictly defined criteria, 48 patients were judged to have Crohn's disease in a retrospective 10 year survey of Dunedin Hospital case notes. An apparent increase in the frequency of this disease in the Otago area is documented. Age (mean 39.5 years) and sex distribution (female/male:1.6/1) of cases and the patterns of clinical presentation are in accordance with similar studies in other countries. Mean follow up was for 28 months (range 3-108 months). The dominant localisation of the disease was to the large bowel only (60%), or large bowel plus terminal ileum (17%) with only 23% having disease confined to the small bowel. This is the reverse of experience in a similar survey recently reported from Auckland. No cases were detected in Polynesians in either survey. The difficulty of early and accurate diagnosis of Crohn's disease is emphasised. Although 21 (44%) of the patients required some surgery, no deaths were recorded in these patients.

Adolescent↗
PubMed1984

Prospective evaluation of patients with upper gastrointestinal haemorrhage.

A prospective study was conducted to collect data on clinical and endoscopic diagnosis, associated factors and outcome of 112 consecutive patients with acute upper gastrointestinal haemorrhage admitted to the Dunedin public hospitals over an 18 month period. The mean interval between admission and endoscopy was 20.2 hours. There was a poor correlation between the provisional clinical diagnosis and the endoscopic diagnosis. The causes of bleeding were demonstrated at endoscopy in 87.5% of patients. A history of salicylate, non-steroidal anti-inflammatory drug or significant alcohol ingestion was present in about two-thirds of patients with mucosal abnormalities. The incidence of continued or repeated bleeding was 16%; peptic ulcers accounted for half of these patients. The presence of active bleeding or a visible vessel or blood clot on the ulcer surface indicated a 33% chance of rebleeding; none of the peptic ulcer patients without these signs rebled. Surgery was performed in 11.6% of patients, predominantly for peptic ulcer. The overall mortality was 8% (reducing to 5.4% if patients dying in hepatic failure are excluded), most of the deaths occurring in older patients with complicating medical conditions, and not from uncontrolled haemorrhage.

Adolescent↗
PubMed1983

A comparison of oxmetidine and cimetidine in the treatment of duodenal ulcer.

Oxmetidine (1 g/day), a new histamine H2-receptor antagonist, or cimetidine (1 g/day) was given to 30 patients with endoscopically proven duodenal ulcers in a randomised, double-blind trial. Ulcer healing was assessed endoscopically after four weeks' treatment, and again at eight weeks in those who had not healed in the first four weeks. Of the 15 patients receiving oxmetidine, 11 (73 percent) had healed their ulcers in four weeks, while 14 (93 percent) had healed their ulcers in eight weeks. Comparable healing rates were found with cimetidine, namely 13 of 15 (87 percent) after four weeks and all 15 patients (100 percent) after eight weeks. The patients were relieved of their symptoms to a comparable degree with both drugs. Weekly clinical, haematological and biochemical monitoring failed to reveal any relevant adverse effects except for a mild asymptomatic rise in serum creatinine levels with both oxmetidine and cimetidine.

Anti-Ulcer Agents↗
PubMed1982

Sensitivity of the parietal cell to pentagastrin in health and duodenal ulcer disease: a reappraisal.

In view of the conflicting results on whether pentagastrin sensitivity is genuinely increased in duodenal ulcer (DU) patients, the pentagastrin-gastric acid relationship was restudied in 17 normal subjects and 15 DU patients. In a reproducibility study performed on nine healthy subjects the mean pentagastrin responses obtained on 2 different study days, using a step technique (range, 0.025-6.4 micrograms kg-1h-1), were congruent at each of the five measuring points. Analysis of variance revealed no significant overall differences. However, ED50 values showed a large within- and between-subject variation and failed to correlate significantly, this because a plateau response was not regularly obtained with the top dose. Consequently, ED50 values in normal subjects and DU patients showed a large scatter and were not significantly different, although the potency ratio calculated from the linear parts of the respective dose-response curves was significantly different (2.6; 95% confidence limits, 1.8-3.9). This study thus supplies further evidence that the parietal cell of DU patients has a higher sensitivity to pentagastrin and demonstrates that the reliability of individual ED50 estimations obtained in pentagastrin dose-response studied should not be overrated.

Adult↗
PubMed1981

Clinical experience with impromidine, a highly specific H2-receptor agonist.

The gastric secretory response to impromidine (SKF 92676), a potent selective histamine H2 agonist, has been studied in 40 patients with peptic ulcer disease or ulcer-like dyspepsia. Peak acid output following the intravenous infusion of impromidine, 10 micrograms kg-1h-1, or pentagastrin, 6 micrograms kg-1h-1, was not significantly different. This was also the case when the two drugs were administered subcutaneously at the same dose. Impromidine was well tolerated with only minor effects on the cardiovascular system both in 10 younger patients and in 20 subjects over the age of 55 years with mild to moderate cardiovascular disease. Impromidine can be considered an important tool for further investigation of the role of histamine at the H2-receptor site in man.

Adult↗