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Biomedical subjects

R J Gribble

Publications and source records attributed to R J Gribble.

8 recordsLinked to original sources
PubMed1995

Jumping from a general hospital.

Jumping is the most common reported means of suicide in general hospitals. There have been no published reviews of suicides of nonpsychiatric inpatients since 1980. We describe 12 subjects who, between January 1980 and January 1992, jumped from a large general teaching hospital. Eight of them succumbed, providing a rate of suicide of 1.7 per 100,000 admissions. There were three clinical subgroups: those admitted after suicide attempts, the acutely delirious, and the chronically medically ill. Factors appearing frequently in the third subgroup were pain, dyspnea, transient confusion, poor prognosis, and recent adverse news. When we compared the hospital jumpers with 30 nonfatal jumpers who attended our Emergency Department, the medical and psychiatric profiles differed in the frequency of medical illnesses, advancing age, male gender, and absence of preexisting psychiatric illness. Proximity and ease of access to balconies and windows appeared to be highly relevant to the prevention of hospital jumping.

Adolescent↗
PubMed1985

Basal, sham feed and pentagastrin stimulated gastric acid, pepsin and electrolytes after omeprazole 20 mg and 40 mg daily.

Gastric secretion was measured in nine patients with duodenal ulcer before, and after treatment for four weeks with omeprazole 20 mg or 40 mg daily. Basal acidity and acid output were affected variably by 20 mg, but inhibited totally by 40 mg daily. Sham feed stimulated acid output was reduced by 20 mg daily and completely inhibited by 40 mg daily. Maximal pentagastrin stimulated acid output was halved by 20 mg omeprazole daily and 84% inhibited by 40 mg daily. The reduction in acidity was always greater than the reduction of volume. Pepsin output after pentagastrin was little altered but with the reduced secretory volume pepsin concentrations were increased by both doses. The major cause of reduced aspirate acid output after omeprazole is decreased secretion of the primary acid component of the parietal cell by the proton pump H+K+ ATPase. Duodenogastric alkaline reflux is, however, markedly increased after omeprazole and is an additional factor in the resultant hypoacidity or even anacidity after this drug.

Adult↗
PubMed1980

Serum carbenoxolone: ulcer-healing and metabolic effects.

The relationship of serum carbenoxolone to dosage, age, sex, efficacy and side-effects were studied in 92 patients. Log serum carbenoxolone was correlated with dose and with age, and was higher in women. Serum levels were not significantly different in those patients with duodenal (or gastric) ulcer whose ulcers had or had not healed after allowance was made by analysis of variance for the effects of age and sex. However, oedema and hypokalaemia were associated with higher serum levels. These results support the concept that the ulcer-healing effect of carbenoxolone is topical rather than systemic.

Adult↗
PubMed1980

The influence of amiloride on the therapeutic and metabolic effects of carbenoxolone in patients with gastric ulcer. A double-blind controlled trial.

Patients with benign gastric ulcer were treated for four weeks with carbenoxolone sodium as Biogastrone tablets 100 mg three times a day, and if the ulcers were not healed at 4 weeks treatment was continued for a further 4 weeks. Fifty two patients entered the trial, and 12 were withdrawn. In 17 patients who were randomly allotted double-blind additional dummy tablets 16 of their ulcer healed completely endoscopically, whereas of the 23 patients given additional amiloride 5 mg three times a day only 14 ulcers healed, a significant reduction in ulcer healing. The clinical (weight gain and oedema) and metabolic (hypertension, hypokalaemia and hypernatraemia) side-effects were reduced by the active amiloride therapy, but serum carbenoxolone levels were not affected. Thus the potassium-retaining diuretic amiloride, like the aldosterone antagonist spironolactone, markedly reduces both the ulcer-healing and the metabolic side-effects of carbenoxolone sodium, and should not be used together with it in the treatment of peptic ulcer.

Adult↗