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Biomedical subjects

E Goldin

Publications and source records attributed to E Goldin.

120 records · Page 7Linked to original sources
PubMed1985

Comparison of misoprostol and cimetidine in the treatment of duodenal ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and cimetidine in the treatment of duodenal ulcer was evaluated. Seventy-one patients with endoscopically proven duodenal ulcer were randomized in a double-blind manner in one of three groups that received four daily doses of either misoprostol, 50 or 200 micrograms, or cimetidine, 300 mg. Ulcer healing was assessed endoscopically after 4 weeks of treatment. The mean age, sex distribution, and tobacco, alcohol and caffeine consumption were similar in all treatment groups. Only one patient was lost to follow-up. On the misoprostol low dose, healing of the ulcer was observed in 60.9% of the patients. In contrast, healing on the higher dose of misoprostol was not significantly different to that with cimetidine. No significant clinical or laboratory side effects were observed in any of the patients. We found that the daily dose of 800 micrograms misoprostol is safe and effective in the treatment of duodenal ulcer.

Adult↗
PubMed1985

Comparison of misoprostol and cimetidine in the treatment of gastric ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and cimetidine in the treatment of gastric ulcer was evaluated. Thirty-two patients with endoscopically proven gastric ulcer were randomized, in a double-blind manner, in one of three groups that received four daily doses of either misoprostol, 50 or 200 micrograms, or cimetidine, 300 mg. Ulcer healing was assessed endoscopically after 4 weeks of treatment. The three groups were fairly comparable in their alcohol and caffeine intake, previous ulcer history and ulcer size. A relatively high proportion of patients in the cimetidine-treated group was smokers. Only one patient was withdrawn from the study. On the misoprostol low dose, healing of the ulcer was observed in 20% of the patients. In contrast, healing on the high dose of misoprostol (70%) was not significantly different from that on cimetidine (73%). No important clinical side effects were observed in any of the patients. These results (part of a multicenter, international study) suggest that the divided daily dose of 800 micrograms misoprostol is safe and effective in the short-term treatment of gastric ulcer.

Adolescent↗
PubMed1985

Esophageal involvement by pemphigus vulgaris.

Pemphigus vulgaris is a well-known disease that involves the skin and the mucous membranes. The disease can start in the oral or pharyngeal mucosa and the skin lesions may appear later. Esophageal involvement seems to be very rare. In a patient with oral disease, we recently observed, at endoscopy, typical lesions of pemphigus vulgaris in the esophagus.

Esophagoscopy↗
PubMed1984

Ileoscopic diagnosis of terminal ileitis.

Crohn's disease of the bowel is usually diagnosed by complete barium contrast studies of the gastrointestinal tract. However, at times, in spite of a high index of clinical suspicion, the radiologic diagnosis is not conclusive. In the present report, we describe five patients with Crohn's ileitis in whom the diagnosis was established only at ileoscopy.

Adolescent↗
PubMed1983

Prostanoids cytoprotection for maintaining remission in ulcerative colitis. Failure of 15(R), 15-methylprostaglandin E2.

To establish whether the cytoprotective properties of prostanoids can be used for maintaining remission in ulcerative colitis, 24 patients with ulcerative colitis in remission were randomly assigned to receive either 15(R), 15-methyl-PGE2 (200 micrograms/day) or to continue with sulfasalazine (2.0 g/day) for up to 28 weeks. All patients included were symptom free and sigmoidoscopy and rectal biopsy performed upon entering the trial did not reveal any signs of disease activity. Of the 12 patients who discontinued sulfasalazine and were allocated to receive 15(R), 15-methyl-PGE2, five flared up within the first four weeks and three others had to stop the trial because of severe diarrhea. Because of the high incidence of side effects and flare-up, the other four patients were instructed to stop the trial. In contrast, only two of the 12 sulfasalazine-treated patients flared-up and the other 10 concluded the 28 weeks of the trial symptom free. These results indicate that 15(R), 15-methyl-PGE2 cannot be used to control and support remission in ulcerative colitis patients.

Adult↗
PubMedDate not supplied

Severe acute pancreatitis as the presenting symptom of primary sclerosing cholangitis: treatment by endoscopic insertion of a biliary stent.

Primary sclerosing cholangitis is a chronic, fibrosing, inflammatory condition of unknown origin of extra and intrahepatic bile ducts. Recurrent cholangitis and jaundice are the most frequent clinical manifestation in symptomatic patients. We report a patient with primary sclerosing cholangitis presented with recurrent attacks of acute pancreatitis. Such a combination was not reported till now in the literature. The acute pancreatitis was probably due to reflux of bile and sludge into the pancreatic duct due to stricture of the distal part of a common bile and pancreatic ducts. Endoscopic insertion of a biliary stent managed to prevent jaundice and recurrent pancreatitis.

Acute Disease↗
PubMedDate not supplied

New endoscopic palliative treatments in gastrointestinal malignancies.

Many gastrointestinal cancers are diagnosed when no curative approach is possible. Patients with these malignancies frequently have dysphagia, jaundice, intestinal obstruction and other severe symptoms which significantly impair their quality of life. We present our experience with two new endoscopic techniques for palliative treatment in these patients: placement of biliary endoprostheses to alleviate malignant obstructive jaundice and destruction of neoplastic tissue by phototherapy with laser rays.

Cholestasis↗
PubMedDate not supplied

Treatment of primary and metastatic liver cancer using an implantable chemoinfusion pump.

Twenty evaluable patients with primary or secondary neoplastic liver involvement received FUDR (0.2 to 0.3 mg/kg per day) by continuous infusion to the hepatic artery for 14 days, every 4 weeks, through a surgically implanted Infusaid (USA) pump. In addition to FUDR, MMC (15 mg/m2 every 6 to 8 weeks) was given to 14 patients with colorectal cancer and one patient with breast cancer, and ADR, (40 mg/m2 every 4 to 6 weeks) was given to 5 patients with hepatocellular carcinoma. MMC and ADR were given as a bolus injection, through the pump sideport. Radiation therapy to the liver (2,000 rads in fractions of 180 to 200 rads each) was given to eight patients with colorectal carcinoma. In total, the 20 patients received 218 months of treatment and 580 injections. The overall remission rate (complete, partial and minor response) was 55%; one patient with a colorectal carcinoma achieved a CR and seven patients (35%) a PR; three patients (15%) had a MR, and in eight patients (40%) stabilization of disease was observed. Overall median survival was 12 months: 15.5 months for colorectal cancer patients and 7.5 months for patients with hepatocellular carcinoma. Toxicity consisted mainly of chemical hepatitis, mild to severe peptic disease and sclerosing cholangitis. Hematological toxicity was not observed. These data suggest that chemotherapy through the hepatic artery, while still experimental, may be considered for selected patients with tumor confined to the liver.

Adult↗