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Biomedical subjects

O Bonnevie

Publications and source records attributed to O Bonnevie.

At least 19 recordsLinked to original sources

Acyclovir in the prevention of duodenal ulcer recurrence.

This study tests the hypothesis that reactivation of a latent herpes simplex virus infection may be a cause of recurrent duodenal ulceration. Patients with recently healed duodenal ulcer were entered into a double blind, randomised study of maintenance treatment with the antiviral drug acyclovir (400 mg bid) versus placebo, to determine if suppression of herpes virus infection would influence the natural history of the ulcer disease. One hundred and fifteen patients entered the trial and 76 patients completed it according to the protocol. Endoscopy was performed when ulcer symptoms recurred and at the end of the 25 week trial period. In the acyclovir group the cumulated relapse rate was 63% compared with 56% in the placebo group (NS). This result suggests that reactivation of herpes simplex virus is not a cause of recurrent duodenal ulcer.

Acyclovir

Gastric ulcer therapy with a pepsin-inactivating peptide, pepstatin: a double-blind randomized clinical trial.

Sixty consecutive patients with gastric ulcer were studied at random after treatment with 100 mg pepstatin or 100 mg placebo seven times a day at fixed hours and controlled 2, 4, 8, and 12 weeks after initial diagnosis. Examinations comprised clinical symptoms and endoscopic evaluation of ulcer healing. Eight patients were withdrawn from the study. Ulcer healing and symptoms were better with placebo than with pepstatin, but a type-2 error of a 10% effect in favour of pepstatin may be overlooked. In gastric ulcer treatment, pepstatin seems to be of only fringe benefit, if of any benefit at all.

Clinical Trials as Topic

Survival in peptic ulcer.

The present study of the prognosis in peptic ulcer comprises (1) an analysis of deaths caused by the disease itself, and (2) an independent actuarial analysis of life expectancy. The computations are based on 235 deaths that occurred among 1905 patients with peptic ulcer who constituted a random sample of the occurrence of ulcer disease in an area of Denmark comprising half a million inhabitants. The two methods of analysis both showed that peptic ulcer does influence the survival, but the excess of deaths was small and, in the case of solitary peptic ulcer, was present only in the first year or two after the diagnosis. The prognosis tended to be more serious in gastric ulcer than in duodenal ulcer, but the difference was not significant. In duodenal ulcer the survival tended to be better when only a deformed bulb was present. The life expectancy was not significantly different for men and women. Patients with combined gastric and duodenal ulcers had a fatality twice as great as those with solitary ulcers. No excess of deaths was found in patients under the age of 50 years at diagnosis. The duration of prediagnostic symptoms was not predictive for the prognosis.

Adult

Long-term prognosis of duodenal ulcer: follow-up study and survey of doctors' estimates.

In 1976 we reviewed a randomly selected cohort of 227 patients with duodenal ulcer first diagnosed in 1963. The cohort comprised cases diagnosed in both hospitals and general practice. Fifty patients had died, 12 had emigrated, and 154 (93%) of the remaining patients were interviewed. Fifty-seven medically treated patients had no symptoms, 44 had mild symptoms, and 19 had more severe symptoms. The remaining 34 patients had been treated surgically. Cases diagnosed in hospital had a more severe prognosis than those diagnosed in general practice. A random sample of 65 general practitioners and 78 medical and surgical gastroenterologists tried to predict the results of this study. The range of the predictions was very wide showing that individual prognostic estimates were highly unreliable. The mean prediction by all doctors differed little from the actual result, suggesting that the collective experience of the medical profession is more reliable. The predictions of general practitioners, physicians, and surgeons showed small systematic differences, presumably reflecting the different types of patients they treat.

Adolescent

Causes of death in duodenal and gastric ulcer.

An analysis has been made of 235 deaths that occurred among 1905 patients with peptic ulcer who constituted a random sample of the occurrence of ulcer disease in an area of Denmark comprising half a million inhabitants. The disease itself, according to the death certificate, was considered the primary cause of death in 10% of the cases; half of these had been operated on immediately before death. The other patients died more frequently than expected from the following causes: chronic bronchitis, pulmonary emphysema, cancer of the lung, cirrhosis of the liver, and cancer of the pancreas. Although the comorbidity with chronic bronchitis and emphysema was especially pronounced in patients with gastric ulcer, the association with liver cirrhosis and cancer of the pancreas occurred only in patients with duodenal ulcer. In women the mortality rate attributable to cardiac and vascular diseases was lower than expected. No excess coincidence of suicide was found. Berkson's fallacy is considered to be of much less importance as a possible explanation of the comorbidity found in the present study than in the majority of publications concerned with this question.

Adult