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Biomedical subjects

P Snel

Publications and source records attributed to P Snel.

15 recordsLinked to original sources
PubMed1990

Effect of long-term treatment with omeprazole on serum gastrin and serum group A and C pepsinogens in patients with reflux esophagitis.

Twenty-nine nongastrectomized and three partially gastrectomized patients with chronic reflux esophagitis resistant to 12 weeks' treatment with histamine H2-receptor antagonists were treated with a daily oral dose of 20-40 mg of omeprazole for 12-30 months. Basal serum gastrin, serum pepsinogen A, and serum pepsinogen C concentrations were monitored at regular intervals. Serum gastrin levels significantly (P less than 0.01) increased threefold to fourfold during the first 1-2 months of the study when all patients ingested 40 mg of omeprazole daily. Dose reduction to 20 mg did not significantly decrease gastrin levels. Serum gastrin levels showed a trend to further increase after the first 3 months of treatment, reaching statistically significant differences for values from the 3-12-month period (P less than 0.05) and from the 3-24-month period (P less than 0.005). Women and patients with high basal serum gastrin levels before omeprazole treatment were more likely to achieve higher serum gastrin levels during omeprazole treatment. Serum pepsinogen A and C levels were significantly (P less than 0.01) increased at all time intervals during long-term treatment with omeprazole. No significant tendency toward higher serum pepsinogen C levels in time was observed. However, serum pepsinogen A levels and the ratio of pepsinogen A to pepsinogen C further increased significantly (P less than or equal to 0.05) during the initial 3-12-month period. However, this trend was not observed anymore afterward. Antrectomized patients did not show increases in serum gastrin and serum pepsinogen A and C levels, suggesting that hypergastrinemia may be involved in the observed hyperpepsinogenemia.

Aged↗
PubMed1989

Efficacy of the H+/K+-adenosine triphosphatase inhibitor omeprazole in peptic ulcer.

In duodenal ulcer studies comprising more than 2,000 patients the efficacy of omeprazole in doses of 20-40 mg once daily has been compared with the recommended doses of the H2-receptor antagonists cimetidine and ranitidine. At 2 weeks the differences in healing rates in favour of omeprazole were 12-33%; while they were somewhat lower at 4 weeks, ranging from 4 to 20%. In most studies the difference in healing rate was statistically significant. In some studies pain relief at 2 weeks was more pronounced on omeprazole. In three gastric ulcer studies omeprazole in doses of 20 or 40 mg once daily has been compared with ranitidine 150 mg twice daily. Healing rates on omeprazole were significantly greater in 2 of the 3 studies. Pain relief was faster on the higher dose of omeprazole. In prepyloric gastric ulcer the healing rate at 2 weeks was not significantly greater on 20 or 40 mg omeprazole than on ranitidine, while in another study the healing rate was significantly greater on 30 mg omeprazole as compared with cimetidine. In the first week of treatment more patients on omeprazole became free of pain in the latter study. The relapse rate after stopping therapy was similar for omeprazole and the H2-receptor antagonists independent of the type of ulcer. In conclusion, omeprazole heals ulcers faster than the recommended doses of H2-receptor antagonist. The difference in healing rate is more pronounced halfway than at the end of the treatment course.

Cimetidine↗
PubMed1989

Use of omeprazole in the management of reflux oesophagitis resistant to H2-receptor antagonists.

Severe reflux oesophagitis, which is resistant to treatment with high doses of H2-receptor antagonists, can be treated successfully with the H+,K+-ATPase inhibitor omeprazole. Experience from more than 3 years of continuous treatment with omeprazole, in doses adjusted to prevent recurrences, has demonstrated its high efficacy in the long-term management of the patients. The use of this drug emphasizes the importance of long-standing, effective, 24-hour acid inhibition for reflux oesophagitis. Fasting gastrin levels increase 2-fold during the initial treatment period but continued treatment does not induce any further elevation. Omeprazole does not induce pathological changes in the endocrine cell population of the gastric oxyntic mucosa, though in some patients an increase in the argyrophilic cell volume density during omeprazole treatment has been reported. Careful surveillance of the safety profile of this drug is continuing.

Esophagitis, Peptic↗
PubMed1979

[Percutaneous transhepatic cholangiography with the Okuda or Chiba needle (author's transl)].

Introduction of the thin flexible needle (Chiba or Okuda needle) has revived percutaneous transhepatic cholangiography, even though there are more recent methods of investigating the biliary tract. Personal results in 65 patients demonstrate that the needle can be successfully introduced in all instances, as long as the biliary tracts are dilated, the success rate being 68% if they are not. The complication rate was 9.2%, but there was no death.

Adolescent↗
PubMed1979

Maternal mortality due to the hepatorenal syndrome of pre-eclampsia. A case report.

A maternal death in the 23rd wk of pregnancy is described. The patient was gravida 8, with 6 previous abortions and one growth-retarded term infant. The clinical symptoms and biochemical findings strongly suggest that the mode of death was septic shock, with the hepatorenal syndrome due to pre-eclampsia as the underlying cause.

Adult↗
PubMed1978

[The radiological diagnosis of the Zollinger-Ellison syndrome (author's transl)].

The article discusses the y-ray diagnosis of the Zollinger-Ellison syndrome, including 13 with multiple endocrine adenomatosis, Type I. This syndrome is governed by complex pathophysiological processes determining the x-ray symptoms. Besides the predisposition to ulcers, which will persist despite partial gastrectomy, changes at the duodenum (hypertrophy of Brunner's glands) and proximal jejunum (bulging of folds) are relatively typical. However, the final diagnosis of the Zollinger-Ellison syndrome is a clinical one. The syndrome is caused by non-beta islet cell tumors of the pancreas, associated with hypergastrinemia. Since these tumors are often multiple and small, angiography is not very rewarding. It is frequently impossible to distinguish the benign from the malignant tumors on the grounds of histological findings, the only criterion being their biological behaviour, if the exclusion or identification of metastases.

Adult↗
PubMed1977

A portable heart rate distribution recorder for studying daily physical activity.

This paper provides a brief description of a new 8-register heartbeat integrator for recording the heart rate over a long period (24-h or more) in order to assess daily physical activity in children and adults. This compact, rugged device records the cardiac beat to beat interval in seven registers, ranging from 40--225 H4/min. An eight register, the so called "quality level"; (range 225--300 Hr/min) is added to count all non-physiological pulses resulting from muscle noise, etc. To test for validity this system was evaluated simultaneously against two established systems; a manual acoustic monitoring system and a heart rate recording system. Comparison of the results demonstrated good agreement. Integrator influences on the normal daily activity behaviour of the children (age 5 yrs.) was checked with the pedometer method. It was found that wearing of the heartbeat integrator did not appreciably influenced the normal behaviour of the children.

Biomedical Engineering↗
PubMed1977

A portable miniature solid-state heart rate recorder for monitoring daily physical activity.

A compact, rugged, solid-state heart rate recorder (63 X 94 X 22 mm, 195 g) to measure normal daily heart rates over periods of up to 33 h is described. With an interval switch a selection can be a mean heart rate over 30, 60 or 120 sec. The ECG amplifier filter is equipped with an automatic gain control to eliminate R-wave amplitude changes during physical activity. A continuous acoustic check on correct electrode attachment and sufficient signal amplitude is possible by means of an earphone. Data may be stored on punch tape, tape recorder, or processed on-line, or plotted directly one a line writer to obtain a heart rate profile over the measured time. In 45 studies with adults and children the heart rate recorder has proven to be a reliable instrument.

Activities of Daily Living↗