Search PubMed⌕ Search

Biomedical subjects

D A Burke

Publications and source records attributed to D A Burke.

34 records · Page 2Linked to original sources
PubMed1989

Ulcerative colitis: prolonged remission following azathioprine-induced pancytopenia.

The patient reported here has had prolonged remission following a chronic relapsing course of ulcerative colitis requiring frequent use of systemic steroids. All inflammatory bowel disease symptoms resolved after treatment with azathioprine, which was associated with the development of pancytopenia. The patient remains in clinical, sigmoidoscopic, and histological remission 56 months after receiving azathioprine.

Adult↗
PubMed1988

Adhesive Escherichia coli in inflammatory bowel disease and infective diarrhoea.

The clinical features of ulcerative colitis and Crohn's disease are similar to those of infections of the bowel, although their cause is uncertain. Many bacteria that cause intestinal diseases adhere to the gut mucosa, and adhesion of pathogenic Escherichia coli is resistant to D-mannose. The adhesive properties of isolates of E coli were assessed by assay of adhesion to buccal epithelial cells with mannose added. The isolates were obtained from patients with inflammatory bowel diseases (50 with a relapse of ulcerative colitis, nine with ulcerative colitis in remission, 13 with Crohn's disease, and 11 with infectious diarrhoea not due to E coli) and 22 controls. The median index of adhesion to buccal epithelial cells (the proportion of cells with more than 50 adherent bacteria) for E coli from patients with ulcerative colitis in relapse was significantly higher (43%) than that for controls (5%) and patients with infectious diarrhoea (14%). The index was not significantly different among isolates from patients with ulcerative colitis in relapse, Crohn's disease (53%), and ulcerative colitis in remission (30%). If an index of adhesion of greater than 25% is taken as indicating an adhesive strain 86% of isolates of E coli from patients with inflammatory bowel disease were adhesive compared with 27% from patients with infective diarrhoea and none from controls. The adhesive properties of the isolates from patients with inflammatory bowel disease were similar to those of pathogenic intestinal E coli, raising the possibility that they may have a role in the pathogenesis of the condition; the smaller proportion of adhesive isolates in patients with infective diarrhoea due to other bacteria suggests that the organism may be of primary importance rather than arising secondarily.

Bacterial Adhesion↗
PubMed1988

Lymphocytic gastritis--relationship to Campylobacter pylori infection.

The existence of a distinctive form of chronic gastritis characterized by marked infiltration of the surface and pitlining epithelium by mature T lymphocytes has been confirmed. Seventeen cases were identified amongst 382 patients with active chronic gastritis (4.5 per cent). The cases with lymphocytic gastritis had significantly higher counts of intraepithelial lymphocytes than sex and age-matched controls drawn from a series of patients with the usual form of active Type B chronic gastritis. Furthermore, the lymphocytic gastritis group exhibited unusual endoscopic findings, namely erosions and 'raised lesions', in the body of the stomach. Such appearances have been previously described as 'varioliform' gastritis. Only seven of the patients (41 per cent) had C. pylori-positive biopsies, compared with over 90 per cent in the generality of active chronic gastritis, but all but two of the eleven cases tested had serological evidence of C. pylori infection. While the pathogenesis of this condition is unclear, the histological resemblance to coeliac disease suggests that lymphocytic gastritis might also represent an abnormal response to a local antigen to which the patient has become sensitized. It is possible that this antigen is C. pylori.

Adult↗
PubMed1988

Hydrophobic adhesin of E coli in ulcerative colitis.

Pathogenic E coli have adhesive properties which are mirrored by an increase in their surface hydrophobicity. E coli isolated from patients with ulcerative colitis possess a mannose resistant adhesin similar to that found in pathogenic E coli. In this study 42 E coli isolates from patients with colitis have been compared with 15 from controls to assess hydrophobicity and cellular adherence. The salting out method and the buccal epithelial cell technique were used respectively. E coli isolated from colitics are significantly more hydrophobic than control E coli (p less than 0.001). The salting out score correlates negatively with the buccal epithelial cell adhesion index. When E coli are grown at 18 degrees C both properties are temporarily reduced suggesting that they are related to each other. The salting out method clearly differentiates between E coli isolated from colitics and controls, and offers a simple method of detecting adhesive E coli in inflammatory bowel disease.

Adhesins, Escherichia coli↗
PubMed1988

Oral bowel lavage preparation for colonoscopy.

Colonoscopy is a commonly performed diagnostic and therapeutic procedure in most general hospitals, which requires effective bowel preparation to be worthwhile. We report the effect of replacing a diet, laxative and bowel washout preparation with oral bowel lavage using a balanced electrolyte formulation, in our unit. The preparation was acceptable to patients, medical and nursing staff, generally preferred to previous preparations by those who had experienced them, allowed a more complete colonoscopy with an excellent quality of view, and was less expensive in nursing time. We regard oral bowel lavage as currently the method of choice for bowel preparation prior to colonoscopy in the majority of patients.

Administration, Oral↗
PubMed1987

Adverse reactions to sulphasalazine and 5-amino salicylic acid in the same patient.

We report a patient who developed sulphasalazine-related hepatitis with a subsequent adverse reaction to rectal 5-amino salicylic acid, in the form of pain and fever without associated liver dysfunction, suggesting reactions to both components of sulphasalazine. Included is a review of the literature. Caution should be observed when prescribing 5-amino salicylic acid to sulphasalazine-intolerant patients.

Adult↗
PubMed1987

HeLa cell and buccal epithelial cell adhesion assays for detecting intestinal Escherichia coli with adhesive properties in ulcerative colitis.

The two methods used to detect intestinal Escherichia coli in patients with ulcerative colitis, HeLa cell and buccal epithelial cell (BEC) adhesion assays, were compared. Both methods showed a significant difference between the adhesive property of colitic and control E coli: p less than 0.0002 and p less than 0.01 for the buccal epithelial cell and HeLa cell methods, respectively. HeLa cells did not detect all BEC positive isolates which were quantitatively more adhesive than any control isolate. All BEC negative isolates were HeLa cell negative. The BEC technique seems to be more sensitive for detecting adhesive E coli in ulcerative colitis because the true incidence of adhesive E coli in ulcerative colitis was higher than that determined by the HeLa cell method.

Bacterial Adhesion↗
PubMed1987

Ulcerative colitis and Escherichia coli with adhesive properties.

A quantitative assessment of the mannose resistant, adhesive property of Escherichia coli from patients with ulcerative colitis and from controls was made using a buccal epithelial cell adhesion assay, which also permitted assessment of adhesion to cells from other host sources. E coli from patients with ulcerative colitis adhered to buccal epithelial cells to a greater extent than those obtained from controls (p less than 0.0001), but did not show an increased affinity for the buccal epithelial cell of their host, compared with those obtained from other sources. The mannose resistant adhesive property of E coli raises the possibility that it has a role in the pathogenesis of ulcerative colitis.

Bacterial Adhesion↗
PubMed1987

Somatostatin analogue SMS 201-995 long term therapy for vipoma.

The definitive treatment of a pancreatic tumour secreting vasoactive intestinal polypeptide is surgical removal of the tumour, but when curative resection is not possible symptomatic treatment of the endocrine hyperfunction is important. Streptozotocin, although effective for palliation, can involve unpleasant side effects. We report the long term use of subcutaneous somatostatin analogue SMS 201-995 in an elderly man presenting with severe watery diarrhoea and anaemia due to a pancreatic vipoma. Good symptomatic improvement has been achieved with no side effects over a period of 24 months. We suggest there is a use for subcutaneous SMS 201-995 in elderly patients with inoperable pancreatic gut hormone producing tumours with metastases and in those where surgery would carry a high operative risk.

Adenoma, Islet Cell↗
PubMed1987

Clostridium difficile, sulphasalazine, and ulcerative colitis.

Clostridium difficile has been implicated in the relapse of ulcerative colitis. Controversy exists over this role and its relationship to sulphasalazine exposure. Sixty two of 77 patients with a documented relapse of ulcerative colitis were investigated for the presence of Clostridium difficile, or its toxin, prior to hospitalization. There was a low incidence of detection which was related to antibiotic exposure (2/62). Sampling during the treatment period showed that the occurrence of Clostridium difficile in the stool was related to antibiotic treatment (2/66). Fifty six percent of patients were taking sulphasalazine, none of whom became culture or toxin positive. This study demonstrates that Clostridium difficile is not related to relapse of ulcerative colitis and is not secondarily acquired during relapse unless the patient is exposed to antibiotics. Sulphasalazine does not predispose to acquisition of Clostridium difficile. There is no role for routine screening or treatment of Clostridium difficile in ulcerative colitis.

Adult↗