Diagnostic value of fiberoptic bronchoscopy in acquired immunodeficiency syndrome.
Explore the source record for details and available documents.
Acquired Immunodeficiency Syndrome↗
Biomedical subjects
F Khan
Publications and source records attributed to F Khan.
Aspergillomas complicating sarcoidosis. A prospective study in 100 patients.
During a ten-year study period, we evaluated 100 histologically-proven sarcoid patients for the development of aspergillomas. Serum precipitins against Aspergillus antigens were used to screen all patients regardless of sarcoid stage. Twelve patients had serum precipitins and were further investigated with tomography and serial serum precipitins testing. Ten of these 12 patients had aspergillomas and two patients died of massive hemoptysis. No aspergillomas occurred in stages I, II, or non-cystic stage III patients. All ten aspergillomas developed in the 19 stage III patients with cystic parenchymal damage. We believe that aspergillomas in sarcoidosis are not as rare as previously reported, but occur commonly in chronic cystic sarcoidosis. Additionally, we found serial testing for serum precipitins to be valuable both for the screening of cystic sarcoid patients for aspergillomas and for the management of this complication.
Adult↗
Depression of lymphocyte traffic in sheep by induced systemic arterial hypotension and by acute arterial occlusion.
Shock and arterial insufficiency have been observed to be associated with increased levels of sepsis and mortality. As the vast majority of small recirculating lymphocytes reach lymph nodes in arterial blood, the haemodynamic components of lymph node function would appear to be of importance. Lymphocyte traffic in sheep, as mirrored by the output of lymphocytes into the efferent lymph of popliteal lymph nodes, obtained by chronic cannulation of efferent lymphatics, was found to be sharply depressed both by intravenous nitroprusside infusion induced systemic arterial hypotension and by acute femoral arterial ligation on the side of the study node. In the nitroprusside infusion induced arterial hypotension studies, the depressions in lymphocyte traffic were closely related to the depressions in systemic arterial blood pressure. Excellent colateral circulation and compensatory physiological mechanisms in the sheep limited the duration of these depressions in lymphocyte traffic.
Animals↗
Pirenzepine, cimetidine and placebo in the long-term treatment of duodenal ulceration. A comparative study.
Sixty patients with endoscopically proven healed duodenal ulcers were treated for a year with either pirenzepine (Gastrozepin; Boehringer Ingelheim) 100 mg daily, cimetidine 400 mg at night, or placebo, The monthly relapse rate (patients per month) in the first 3 months (pirenzepine 2,3, cimetidine 2,3, placebo 3,0) and in the next 9 months (pirenzepine 0,33, cimetidine 0,44, placebo 0,56) is lower for pirenzepine and cimetidine than for placebo. This trend is in favour of pirenzepine and cimetidine as effective means of keeping duodenal ulcers in remission. Asymptomatic relapses were also less common with pirenzepine (50%) and cimetidine (45%) than with placebo (64%). No serious side-effects of pirenzepine were observed during the trail.
Adult↗
Bicitropeptide powder and placebo in the treatment of duodenal ulcers. A double-blind endoscopically controlled clinical trial.
In a double-blind study comprising 50 patients with endoscopically proven uncomplicated duodenal ulcers a powder formulation of bicitropeptide (BCP-Compound) was found to be superior to placebo. On endoscopic examination 19 patients (76%) treated with bicitropeptide powder had healed, while 3 (12%) showed some degree of healing, a total success rate of 88%. Only 5 patients (20%) on placebo had healed completely while 3 (12%) showed some degree of healing (chi 2 = 17,9667; P less than 0,0005). Blood and urine bismuth levels were measured before and after 6 and 12 weeks of therapy, and showed an increase after the first 6 weeks. By 12 weeks the levels had decreased, although they were still higher than the initial values. The blood levels were, however, significantly lower than postulated toxic levels.
Adult↗
Factors affecting duodenal ulcer healing. Four double-blind trials in 193 patients.
An analysis of four double-blind endoscopically controlled trials carried out in 1978 -1980 is presented. Drugs utilized were (patient numbers in brackets): a new histamine H2-receptor antagonist ranitidine (25) v. placebo (22), the colloidal bismuth ulcer-coating preparation bicitropeptide (24) v. cimetidine (26), the tricyclic antidepressant trimipramine (20) v. placebo (19), and the disaccharide coating preparation sucralfate (29) v. placebo (28). Factors analysed were smoking, alcohol consumption, age, length of history, sex and race. The prevalence of smoking and alcohol use, age and length of history varied in the four trials. Pronouncements regarding these factors based on small trials are therefore unreliable. There were no overall diffeences in healing rates whether the patient smoked, consumed alcohol, was above or below 40 years of age, or had a history shorter or longer than 1 year. Comparison of drug and placebo responses revealed that the differences between these were most significant in: non-smokers (P=0,0010) compared with smokers (P=0,0288); teetotallers (P<0,005) compared with alcohol consumers (NS); history under 1 year (P<0,005) compared with over 1 year (P<0,025); males (<0,01) compared with females (NS); and Indians (P<0,005) compared with Blacks (NS).
Adult↗
Radioactive iodine uptake by a large cell undifferentiated bronchogenic carcinoma.
Explore the source record for details and available documents.
Carcinoma, Bronchogenic↗
Pneumocystis carinii pneumonia in drug addict.
Explore the source record for details and available documents.
Adult↗
Tri-potassium di citrato bismuthate chewing tablets and cimetidine tablets in the treatment of duodenal ulcers. A double-blind double-dummy comparative study.
A randomized, double-blind, double-dummy comparative 6-week study of tri-potassium di-citrato bismuthate (TDB) (Ulcerone; De-Nol) chewing tables and cimetidine was carried out in 60 patients suffering from duodenal ulceration. The data on 51 patients (27 on TDB and 24 on cimetidine) were analysed (9 patients absconded). Both treatments appeared to be highly effective in ulcer healing at the 6-week endoscopic assessment. The healing rate for TDB chewing tablets was 89% and that for cimetidine tablets 92%. Both forms of therapy were comparable in respect of improvement of pain and effect on all other observed symptoms. Neither drug had a statistically significant effect on any of the haematological or clinical chemical parameters tested during the trial, except that the cimetidine-treated group showed a significant linear reduction in white blood cell count. No side-effects were reported. It is suggested that TDB chewing tablets are a safe, effective and cheaper alternative to cimetidine in the treatment of patients with duodenal ulceration.
Adult↗
Ranitidine in uncomplicated duodenal ulceration. A double-blind endoscopically controlled trial.
Fifty patients with endoscopically proven uncomplicated duodenal ulcers were given either ranitidine 150 mg twice daily or placebo for 4 weeks in a randomized double-blind study. After 4 weeks 76% of patients on ranitidine showed healing. Fifteen (60%) were completely healed, 5 (20%) were partly healed, and 5 had active unchanged ulcers. Of the patients on placebo 6 (27%) were completely healed, 6 (27%) were partly healed, 10 had active unchanged ulcers and 3 had absconded. Grouping partly healed with active ulcers, a Z value of 2,23 was obtained in the Mantel-Haenszel test (P = 0.013 in favour of ranitidine over placebo). Of 10 patients who were partly healed or had active ulcers after being given ranitidine in the first stage of the study, 7 healed on one further course in an open study and 3 still had active ulcers after two further courses. Of 16 patients who were partly healed or had active ulcers after 4 weeks on the placebo, 3 healed on one course of ranitidine, 6 healed on two courses, 6 still had active ulcers after two courses, and 1 absconded. No side-effects were noted. Ranitidine is a safe and effective drug for the treatment of active duodenal ulceration.
Adult↗
Urinary catecholamines, plasma renin activity and blood pressure in newborns: effects of narcotic withdrawal.
Blood pressure and plasma renin activity were studied in 13 infants of drug-dependent mothers (heroin and/or methadone) and 20 control newborns for a period of 21 days. Urinary excretion of epinephrine and norepinephrine were also measured at 24 and 48 h of age. The systolic blood pressure was found to be significantly elevated in newborns of drug-dependent mothers compared with controls (p less than 0.01), but diastolic blood pressure levels were similar. Plasma renin activity was significantly elevated (p less than 0.001) at 48-72 h and urinary epinephrine levels were significantly lower (p less than 0.05) at 24-48 h of age in the drug group, and norepinephrine levels were equivalent. Systolic hypertension and elevated plasma renin activity in these newborns of dependent mothers may be due to increased beta-adrenergic receptor sensitivity.
Catecholamines↗
Relationship of thyroid hormone levels to the severity of the narcotic withdrawal syndrome.
Serum T3, T4 and thyroid stimulating hormone (TSH) were evaluated in 24 neonates of mothers taking methadone and compared with 16 normal controls using cord serum and serum taken on days 1, 2, 3, 4, 7, and 14. Patients were divided into treated (Rx; n = 14) and not treated (No Rx; n = 10) groups based on withdrawal scores and correlated to thyroid hormone levels. T4 levels were greater in the Rx group when compared to controls on days 2, 4 and 7 (p less than 0.01) and when compared to the No Rx group on days 3 and 7 (p less than 0.005). No Rx patients had higher T4 levels when compared to controls on day 4 (p less than 0.05). In general T3 levels paralleled T4 results. TSH levels were decreased in the Rx group compared to No Rx and controls on day 2 (p less than 0.01). Lipsitz scores correlated with T4 levels on days 3, 4, and 7 in methadone patients (p less than 0.05) but did not correlate with T3 or TSH. These findings suggest a correlation between the severity of withdrawal symptoms and T4 and T3 levels.
Female↗
Results of gastric neutralization with hourly antacids and cimetidine in 320 intubated patients with respiratory failure.
In a retrospective analysis massive upper gastrointestinal (GI) hemorrhage, defined as blood loss requiring more than two units of blood transfusion over a 24-hour period, occurred in 40 (9.5 percent) of 420 intubated, mechanically ventilated patients with respiratory failure, irrespective of the etiology of the respiratory failure. In a prospective study hourly antacid gastric neutralization, maintaining the gastric pH over 5, the incidence of massive gastric bleeding was reduced to 3 (1.4 percent) of 210 patients. In 110 additional patients, cimetidine, a histamine H2 receptor blocker, was used to prevent gastric acid secretion; 3 (2.7 percent) of 110 patients had massive upper GI bleeding; all three had solitary chronic pyloric ulcers. We conclude that gastric neutralization, either with hourly antacids or with cimetidine, is effective in reducing the incidence of massive gastric hemorrhage in intubated, mechanically ventilated patients during respiratory failure. We recommend the use of either in all intubated patients with respiratory failure. In addition, in 17 patients who had gastric bleeding at the time of transfer to the respiratory intensive care unit, gastric neutralization with hourly antacids in 14 patients and with cimetidine in three patients stopped the bleeding in all 17 patients within 24 to 48 hours.
Aged↗
Trimipramine in the treatment of active duodenal ulceration.
Forty-five patients with endoscopically proven uncomplicated active duodenal ulcers were placed in a randomised double-blind trial. Six patients were lost to follow-up. Twenty patients received 50 mg trimipramine (Surmontil) at night, and 19 patients received placebo. Complete healing was defined as disappearance of the ulcer, with or without a scar; partial healing was defined as a reduction of ulcer size to 25% of its size, or a large deep ulcer that became flat, if erosions were present even if the ulcer had gone. After 4 weeks of trimipramine treatment 35% had completely healed and 50% had partly healed, compared with 21% completely and 21% partly healed with placebo (chi-square 7.9; p less than 0.025 in favour of trimipramine). There were no side effects. Trimipramine, 50 mg at night, is a safe and effective treatment for active duodenal ulceration.
Antacids↗
A double-blind endoscopically controlled trial of ranitidine in a high incidence area.
Fifty patients with endoscopically diagnosed uncomplicated duodenal ulcers were given ranitidine 150 mg twice daily, or placebo for 4 weeks in a randomised double-blind study. After 4 weeks, 76% of patients on ranitidine showed healing. Fifteen (60%) were completely healed, 5 (20%) were partly healed, and 5 had active unchanged ulcers. On placebo, 6 (27%) were completely healed, 6 (27%) were partly healed, 10 had active unchanged ulcers and 3 had absconded. Grouping partly healed with active ulcers, a Z value of 2.23 was obtained in the Mantel-Haenszel Test; p = 0.013 in favour in ranitidine over placebo. Of ten patients who were partly healed or active after ranitidine in Stage 1, 7 healed on one further course in an open study, and 3 were active after 2 further courses. Of 16 patients who were partly healed or active after placebo, 3 healed on one course of ranitidine, 6 healed on 2 courses of ranitidine, 6 remained active after 2 courses, and 1 absconded. No side-effects were noted. Ranitidine is a safe and effective therapy for active duodenal ulceration.
Adult↗
Short- and long-term studies of duodenal ulcer with sucralfate.
We undertook a series of double-blind studies test the efficacy of sucralfate in the treatment of active duodenal ulcers and the prevention of relapse. In addition, we undertook studies to test the hypothesis that there is a fundamental localized weakness in the duodenum, where ulcers tend to recur. In the short-term study, 80% of patients on sucralfate and 52% on placebo healed their ulcer in 6 weeks (chi 2 = 6.3672; p less than 0.025). The long-term (1-year) study is still underway, but preliminary results show that 37% on maintenance sucralfate and 78% on placebo have had a relapse of duodenal ulcer (Fisher's exact p = 0.0176). A prospective study to ascertain the site of recurrence of duodenal ulcers revealed that 58% recur at the same site in the same quadrant, and a further 31% recur in a adjacent quadrant; thus, a total of 89% recurred in the same hemisphere. We believe this indicates that a weakness in the duodenal cap at a specific site leads to relapse in that area.
Aluminum↗
Variant Turner features in a female with X-isochromosome [46,X, i(Xq)]: is it a distinct clinical entity?
A thirty seven year-old Caucasian female presented with short stature and primary amenorrhea. Employing multiple banding techniques, an isochromosome of the long arm of the X chromosome [i(Xq)] was identified in her peripheral blood and skin fibroblast cultures. This chromosomal abnormality can be interpreted as 46,X,i(X)(qter leads to cen leads to qter). The i(Xq) is late replicating and selectively inactive. The present case was found to have minimal abnormal features when compared with previously published cases. Since patients with i(Xq) have quite variable clinical features, the existence of a distinct clinical entity of "X-isochromosome syndrome" is questioned.
Adult↗
Bicitropeptide and cimetidine in the treatment of duodenal ulcers. A double-blind, double-dummy endoscopically controlled trial.
In a double-blind endoscopic study of 55 patients with uncomplicated duodenal ulcers, treatment with the mucosal-protective agent, bicitropeptide (BCP-Compound), was superior to that with cimetidine (Tagamet) after 6 weeks. After the administration of bicitropeptide, 77% of ulcers had completely healed and 25% had partially healed, and after treatment with cimetidine 38% had completely healed and 38% had partially healed (chi 2 = 6,316; P < 0,025). There was no difference between the results of treatment with either drug at 12 weeks. Patients were followed up 3 months after the ulcers healed, and 44% who had been on bicitropeptide and 72% on cimetidine had active ulcers (no significant difference). Blood and urine bismuth levels were estimated before therapy, after 6 weeks of therapy, and after 3 months without therapy. Results showed that in patients taking bicitropeptide, urine bismuth levels rose significantly between 0 and 6 weeks, but decreased to pretreatment levels after 3 months without therapy. Blood bismuth levels did not change.
Adult↗