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Biomedical subjects

A Walan

Publications and source records attributed to A Walan.

At least 73 records · Page 4Linked to original sources
PubMed1981

On the prevalence of adult coeliac disease in Sweden.

The occurrence of coeliac disease has been less recognized among adults than in children. We have examined the prevalence of adult coeliac disease in a defined population in Sweden, on the basis of results obtained during 7 years' gastroenterological routine practice. On 1 July 1979, the overall prevalence rate was found to be 58/100,000 (1:1700). The age-adjusted rates were unevenly distributed. The peak rate, 130/100,00 (1:750), appearing in the age interval of 45-54 years, indicates that unrecognized middle-aged coeliacs are not symptom-free and that they can be found in routine practice. Our peak rate of coeliac disease unaccompanied by dermatitis herpetiformis is in the same range as the rate found in Swedish children.

Adult↗
PubMed1981

Serum folate determinations in tracing adult coeliacs.

A simple screening test would be helpful in tracing adult coeliacs in medical practice. Results from a gastroenterological routine practice with a high detection rate of coeliac disease showed that a low concentration of serum folate was the commonest abnormality in the serum of adults with this disorder unaccompanied by dermatitis herpetiformis. It occurred in 85%, ranking with steatorrhoea in frequency, and suggests that a serum folate determination could help to refer subjects for jejunal biopsy to detect coeliac disease. In patients found to have a low serum folate recording without a known cause, the predictive value of the low value for adult coeliac disease was examined, and the findings indicate that the investigation of such patients should include jejunal biopsy.

Adolescent↗
PubMed1981

Antacid/anticholinergic, cimetidine, and placebo in treatment of active peptic ulcers.

Seventy-two patients with duodenal (54) or prepyloric (18) ulcers have taken part in a 12-week double-blind trial. Twenty-four patients received cimetidine, 1 g/day; 24 patients received 10 ml of an antacid suspension (buffering 85 mmol acid) 1 and 3 h after every meal and at bedtime and 0.6 mg L-hyoscyamine in sustained-release tablets twice a day; and 24 patients received placebo. The healing rate after 3 weeks' treatment was 67% (p less than 0.005 compared with placebo) with cimetidine, 50% (p less than 0.01) with antacid/anticholinergic, and 13% with placebo. After 6 weeks' treatment 83% were healed with cimetidine (p less than 0.005 compared with placebo), 96% with antacid/anticholinergic (p less than 0.005), and 33% with placebo. A further 6 weeks' treatment gave healing rates of 96% for cimetidine, of 100% for antacid/anticholinergic, and of 50% for placebo. Compared with placebo, cimetidine but not antacid/anticholinergic caused a faster relief of night-time ulcer pain (p less than 0.05). There was a significant correlation between healed ulcers and complete relief of ulcer symptoms (p less than 0.05). In the placebo group the ulcers of nonsmokers healed to a higher extent than those of smokers (p less than 0.05). During 1 year of follow-up there was no difference between the two actively treated groups in number or severity of symptomatic relapses. Time to relapse was, however, significantly shorter after treatment with cimetidine than after antacid/anticholinergic (p less than 0.05). Recurrences occurred more often (p less than 0.05) after slow healing (6-12 weeks) than after fast healing (3 weeks).

Aluminum Hydroxide↗
PubMed1981

Gluten-free diet for dermatitis herpetiformis: the long-term effect on cutaneous, immunological and jejunal manifestations.

In 32 patients with dermatitis herpetiformis (DH) we studied the effect of gluten-free (22 patients) and gluten-reduced (10 patients) diet for periods ranging between 15 and 43 months. Variables such as cutaneous manifestations, dependence on dapsone, IgA deposits in the skin, small-bowel function, and jejunal mucosal morphology were studied. 59% of the patients on gluten-free diet could stop dapsone medication and remain symptom-free, compared with 10% on gluten-reduced diet. The time needed to achieve this therapeutic response varied from 5 to 31 months. IgA decreased in the skin to a degree which roughly paralleled the morphological normalization of the jejunal mucosa. In no patient, however, did the IgA completely disappear. It is suggested that IgA is not the main factor inducing DH symptoms, but rather a secondary phenomenon. Repeated jejunal biopsies revealed normalization of the mucosal histology in 52% of the patients on gluten-free diet, compared with none in the gluten-reduced diet group.

Adolescent↗
PubMed1980

The effects of cimetidine (Tagamet) on renal function in patients with renal failure.

Cimetidine has been administered during 7 days to 28 patients with different degrees of renal failure. Thirteen of these patients had a further week's treatment at least one month later. The daily dose of cimetidine was reduced in relation to pretrial values of creatinine clearance. There was a clear rise in serum creatinine all through the trial (22.3 +/- 2.6% at day 7) (p < 0.001). Maximal decreases in creatinine clearance occurred on day 2 (21.8 +/- 2.2%) and day 3 (23 +/- 2.0%) (p < 0.001), but were still present on days 6 (16.4 +/- 2.9%) and 7 (17.3 +/- 2.8%) (p < 0.001). There was a small rise in serum uric acid all through the trial (p < 0.05). Three days after finished treatment there were no significant differences in serum creatinine, creatinine clearance and serum uric acid when compared to pretrial values. The pattern of changes in serum creatinine and creatinine clearance was the same in both mild and severe renal failure. Glomerular filtration rate determined by |52Cr¿ EDTA clearance before, on day 3 of treatment and 3 days after treatment did not show any differences. No change was seen in serum beta 2-microglobulin during the trial. The decrease in creatinine clearance during treatment with cimetidine is probably not caused by a reduction of glomerular filtration rate, but could be explained by competition by cimetidine for tubular secretion of creatinine. Treatment with cimetidine of patients with renal failure may invalidate measurements of serum creatinine and creatinine clearance as standard routine tests for glomerular filtration rate.

Adult↗
PubMed1979

The absorption of cimetidine before and during maintenance treatment with cimetidine and the influence of a meal on the absorption of cimetidine--studies in patients with peptic ulcer disease.

1 The absorption of a single oral dose of cimetidine taken on a fasting stomach or together with a meal was studied in 28 patients before and during 12 weeks treatment with cimetidine. 2 No significant changes in bioavailability were seen during treatment measured as the area under the blood concentration curve (AUC). 3 AUC after a single dose of 400 mg cimetidine was 2.05 times the area after a 200 mg dose. 4 There was a good correlation between AUC and the dose of cimetidine given corrected for body weight (r=0.89). 5 There was no difference in bioavailability if 200 mg cimetidine was taken on a fasting stomach or together with a beef steak meal. 6. During fasting conditions there was a peak in blood concentration at about one hour followed by a second unexplained peak during the third to fifth hour after dose administration. 7 With food the initial rise in blood concentrations was slower and there was only one peak occurring about 2 h after dose administration.

Adult↗
PubMed1978

Maintenance treatment of recurrent peptic ulcer by cimetidine.

68 patients with chronic peptic ulcer took part in a double-blind trial in which 32 received the histamine H2-receptor antagonist cimetidine, (400 mg twice daily) and 36 received a placebo, for a year. 6 of those on cimetidine had an endoscopically proven recurrent ulcer within a mean of 7 months, while 30 of those on placebo had one after a mean of 4 months (P less than 0.0005). 1 patient on cimetidine had two recurrences compared with 12 patients on placebo (P less than 0.0005). No patient in the cimetidine group had complications compared to 4 patients in the placebo group, 2 of whom had melaena and haematemesis and 2 melaena alone (P less than 0.05). 15 patients on placebo and 1 on cimetidine were referred for surgery during the trial because of symptoms from their recurrent ulcers. Day and night ulcer pain and antacid consumption were significantly less, and general wellbeing better, in cimetidine group. The only probable side-effect of cimetidine was reversible drug-induced liver damage of hypersensitivity type in 1 patient.

Adult↗
PubMed1978

Food-stimulated acid secretion measured by intragastric titration with bicarbonate in patients with duodenal and gastric ulcer disease and in controls.

Gastric acid secretion stimulated by a normally eaten beefsteak meal was measured for 4 h in 16 patients with duodenal ulcer disease (DU), in 9 patients with gastric ulcer disease (GU), and in 14 controls by intragastric titration with bicarbonate to a constant pH 5.5. Reproducibility of the method investigated in 6 DU and in 5 controls gave similar acid secretory values (var. coeff. = 7.5%). DU produced acid on a higher level and with longer duration after food than controls and GU (p less than 0.001). Apart from the second half of the first hour after food, when the acid secretion was higher in controls than in GU (p less than 0.025), there was no significant difference in acid output after food between GU and controls. Maximum gastrin values and 'total gastrin output' after food were significantly higher in GU than in controls, but these differences were not significant between GU and DU and between DU and controls. Fasting gastrin and gastrin levels after food were not correlated to basal acid output or acid output after pentagastrin or food in any of the groups. The maximal acid output after food was higher than the peak acid output after pentagastrin in controls, DU and GU. The relation between food- and pentagastrin-stimulated acid output was not statistically significantly different between the three groups. Instead, acid secretion after food was well correlated to acid secretion after pentagastrin in controls, DU and GU (r = 0.85).

Adult↗
PubMed1978

[Long term effect of ipratropium bromide on gastric secretion].

In a randomised clinical trial in 10 patients, the effects of a new anticholinergic, 8-isopropyl-3 alpha-DL-tropoyloxy-1 alpha H, 5 alpha H-tropanium hydroxide (ipratropiumbromide, active principle of Atrovent), on pentagastrin-stimulated gastric secretion was investigated. The study was performed in comparison to placebo, using the double-blind technique. Each patient served as his/her own control. As earlier test results seemed to indicate that ipratropium bromide had a particularly long duration of action, the special aim of the trial was to clarify whether an oral dose of 30 mg of the product inhibits gastric secretion for more than 11 h after administration. The findings show that basal acid secretion (BAO) was significantly reduced 11 ts following placebo. On the other hand, upon determination of maximum acid secretion (MAO) 12--13 h following administration, there was no difference between the anticholinergic and placebo. The results of the study of the study are discussed.

Atropine Derivatives↗