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Biomedical subjects

E Butruk

Publications and source records attributed to E Butruk.

At least 55 records · Page 3Linked to original sources
PubMed1987

Seasonal prevention of duodenal ulcer recurrences with pirenzepine.

Seasonal accumulation of duodenal ulcer recurrences suggests that maintenance therapy could be limited to the more risky periods. We carried out a 2-year, multi-centre, randomized, double blind study in 250 patients in whom the last ulcer proved to be healed at the endoscopy on entry. One-hundred-and-twenty-six patients in group A were given pirenzepine 2 X 25 mg while 124 in group B had 2 X 50 mg daily from the beginning of January to the end of March, and from the beginning of September to the end of November for two consecutive years. Test endoscopies were performed each year at the end of February, May and November. Both groups proved to be well comparable. Thirty-five patients dropped out from group A in the first and 10 in the second year; in group B 27 and 29, respectively. As the effect did not show any dose relation, the four yearly cycles were summarized. Recurrence rate checked in May was 22.1% while in both pirenzepine protected months it was 11.3% (p less than 0.0005) and 13.4% (p less than 0.001), respectively. We conclude that pirenzepine administered in the risky seasons prevents the peak ulcer incidence and reduces the recurrence rate to a level lower than in the non-risky season. Thus pirenzepine is effective in ulcer prevention even if administered in an interrupted manner.

Adult↗
PubMed1986

Short- and long-term results of colonoscopic polypectomy in children.

Eighty-four colorectal polyps of up to 3.3 cm in diameter were removed with the diathermy snare during 48 colonoscopies on 42 children, aged 2 to 18 years (mean, 7.4 years). Most polyps were juvenile and the majority were located in the sigmoid colon (55%) or rectum (37%). No complications related to medication, colonoscopy, or snare polypectomy were observed. The two presenting symptoms, rectal bleeding and anemia, disappeared soon after polypectomy in all but one patient with adenomatous polyposis coli, subsequently operated upon. Follow-up examinations, including total colonoscopy, performed 4 months to 7 years (mean, 25 months) later did not reveal abnormalities in any of the 37 children whose previously removed polyps were juvenile. The authors conclude that endoscopic snare polypectomy is an effective and safe treatment for colorectal polyps in the pediatric age group.

Adolescent↗
PubMed1985

A conservative approach to adenomas containing invasive carcinoma removed colonoscopically.

A controversy exists as to the correct therapeutic approach to colorectal polyps that contain malignancy and are removed colonoscopically. This paper presents our experience in the management of such polyps. Between 1977 and 1983, a total of 117 patients underwent colonoscopic polypectomy for 178 adenomas. Nine adenomas from nine patients showed carcinomatous invasion across the line of muscularis mucosae. None of these carcinomas was poorly differentiated and in all but two cases there was histologic evidence of complete excision. Seven patients whose adenomas containing foci of malignant changes were treated by polypectomy alone are alive without recurrence at periods from six months to over five years (mean, 40 months). The two patients in whom endoscopic removal of cancerous adenomas was found to be either doubtfully complete or incomplete, had further surgical treatment; both are alive and well after one and five years, respectively. Nine other patients whose adenomas containing malignant changes were considered unsuitable for colonoscopic polypectomy, underwent surgical resection and in none was regional lymph node or distant metastases found at laparotomy. In conclusion, our results of local endoscopic excision for adenomas containing malignant changes suggest a conservative approach to such polyps and this policy is supported by the finding that, in none of our operated patients was there any evidence of metastatic disease.

Adult↗
PubMed1984

Ranitidine in the maintenance therapy of gastro-duodenal ulcer disease: Polish open multicentre study.

Our first stage 3-week trial (6) and second stage up to 6 weeks (7) showed that ranitidine provides the highest healing rate of 97% for duodenal and 95% for gastric ulcer. The study has been now prolonged for one year to assess the efficacy of maintenance therapy. Out of 258 patients who completed the second stage 232 voluntarily entered the open stage 3 in which they were given a single dose R 150 mg nocte, and were endoscopied after 4, 8 and 12 months. There were 153 duodenal and 79 gastric ulcers. 191 patients completed the study; no undesired effects were found and there was no medical reason to withdraw the drug from the long term use. Recurrent ulcer was found in 33.3% out of 126 duodenal ulcer cases, and in 29.2% out of 65 gastric ulcer patients who completed stage three. Sixteen percent of recurrent gastric ulcers and 26% of duodenal ulcers were asymptomatic. Recurrence rate was about twice as high in smokers as in non-smokers. These findings were compared with our long-term endoscopic survey of the natural history of peptic ulcer disease (8) in which yearly recurrence rate of duodenal ulcer was 68.4% and of gastric ulcers 73.5%, 14% of them being painless. This indicates that R is fairly well tolerated in long term use and may be useful to curb the ulcer recurrence rate.

Adult↗