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Biomedical subjects

A R Tanner

Publications and source records attributed to A R Tanner.

43 records · Page 3Linked to original sources
PubMed1979

Efficacy of cimetidine and tri-potassium di-citrato bismuthate (De-Nol) in chronic gastric ulceration: a comparative study.

Sixty patients with benign chronic gastric ulcer were treated in a controlled clinical trial to assess the relative efficacy of cimetidine and tri-potassium di-citrato bismuthate (De-Nol). Patients were assigned at random either to cimetidine or to De-Nol treatment after initial endoscopic diagnosis. Healing was assessed endoscopically after six weeks by an endoscopist who had no knowledge of the patients' treatment. Consumption of analgesic preparations (both for medical and for non-medical reasons), of other anti-inflammatory agents, and of alcohol and cigarettes was recorded. Of the 57 patients who were reassessed at six weeks, 30 had been assigned to De-Nol and 20 of these patients (66%) had completely healed; 27 patients had been assigned to cimetidine and 17 of these (63%) had also completely healed. Those patients who regularly ingested more than four analgesic preparations a day healed less frequently, but this effect was not statistically significant. There was no significant difference between cimetidine and De-Nol in the initial healing of chronic gastric ulceration. The choice of therapy for chronic gastric ulceration will depend on cost, patient acceptance, and data from studies of more complex therapeutic regimens.

Analgesics↗
PubMed1979

Concurrent administration of antacids and prednisone: effect on serum levels of prednisolone.

1 Specific radioimmunoassays have been developed for the measurement of prednisolone and prednisone in serum. 2 Serum prednisolone levels have been measured following the administration of prednisone both with and without antacids. 3 There were no significant differences in the values of Cmax (mean +/- s.d.) (251 +/- 80 ng/ml with, 245 +/- 69 ng/ml without antacid), AUC (1430 +/- 469 ng ml-1 h-1 with, 1406 +/- 530 ng ml-1 h-1 without antacid) or Tmax (1.6 +/- 0.6 h with, 1.6 +/- 0.8 h without antacid). 4 Serum prednisone levels were less than 20% of prednisolone levels at all time intervals in the subjects studied. 5 Concurrent antacid administration has no significant effect on serum prednisolone levels attained.

Antacids↗
PubMed1978

Primary sarcoma of the liver. Report of a case with excellent response to hepatic artery ligation and infusion chemotherapy.

A case of primary undifferentiated sarcoma of the liver in a 66-year-old woman is reported. The similarity of the presenting symptoms to those of a hepatic abscess is emphasized. The patient's response to palliative treatment by means of hepatic artery ligation and chemotherapy was excellent. We believe that this is the first report of such a response in a sarcoma localized to the liver. This therapy may well be useful in symptomatic patients in whom partial hepatectomy is not feasible.

Aged↗
PubMedDate not supplied

Measurement of carbohydrate-deficient transferrin (CDT) in a general medical clinic: is this test useful in assessing alcohol consumption.

The aim of this study was to measure serum carbohydrate-deficient transferrin (CDT) in consecutive patients attending a general medical clinic with a range of alcohol intakes to determine its value in assessing such intake. Eighty-one consecutive patients (42 male, 39 female) aged 20-85 years (median = 49.5 years) attending an out-patient clinic were selected for the study. Each patient completed an alcohol diary detailing the units of alcohol consumed in the previous week, a CAGE questionnaire and an alcohol history, and underwent conventional blood tests including mean corpuscular volume (MCV), liver function tests, and gamma-glutamyl transferase (GGT). CDT was estimated using an enzyme immunoassay (CDTect, Pharmacia). The group comprised of 17 teetotallers, 28 light (<100 g/week), 23 moderate (100-400 g/week), and 13 heavy (>400 g/week) drinkers. Median serum CDT for heavy drinkers (25.5 U/l) was significantly higher than for the rest (median = 17 U/l, Kruskal-Wallis test, P = 0.01). Serum CDT correlated significantly with the CAGE score (Mann-Whitney test, P = 0.01), but poorly with alcohol diary records (r = 0.1, P = 0.4). However the correlations between GGT and diary records (r = 0.43, P = 0.001) and MCV with diary records (r = 0.5, P < 0.001) were significant. Sensitivity, specificity, and positive predictive value for elevated serum CDT were 69, 81 and 41% respectively in detecting heavy drinking. The positive predictive values for the various parameters were 43% for elevated serum GGT, 41% for raised erythrocyte MCV, and 75% for a positive score on the CAGE questionnaire. When a combination of the markers CDT, GGT, and MCV was used, elevation in two of the three markers detected heavy drinking with sensitivity of 85%, specificity of 88%, and positive predictive value of 61%. We conclude that, in out-patients with a wide range of alcohol intakes conventional markers such as serum GGT and erythrocyte MCV were more suitable than serum CDT for assessing alcohol intake. Serum CDT when used in combination with serum GGT and erythrocyte MCV was useful in detecting heavy drinking. The importance of careful history-taking including a standardized questionnaire is emphasized.

Adult↗
PubMedDate not supplied

Information for patients about inflammatory bowel disease.

In inflammatory bowel disease it is important that patients understand their condition since this helps to improve long-term management of the disease. The aim of this study was to assess the information given to patients with inflammatory bowel disease about their condition, its treatment and the National Association for Colitis and Crohn's disease. Two surveys were performed, using anonymous questionnaires. One was of all association members in north-east England, the other was a sample of patients attending medical outpatients. The surveys showed that more patients heard of the National Association for Colitis and Crohn's disease from the media than from medical sources. Of patients seen in medical clinics, 75% would welcome more information about their disease. In four of the six participating centres less than half the patients had been told about the existence of a patients' association. There was considerable variation in the instructions on what action to take in the event of a relapse. These findings suggest that the opportunity offered by out-patient clinics to educate and inform patients is often wasted. Clinicians often neglect to mention the National Association for Colitis and Crohn's disease, especially to patients with long-standing disease. A higher priority should be given to providing patients with appropriate information on inflammatory bowel disease. Three simple audit standards for the organisation of outpatient clinic information are proposed.

Adult↗