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Biomedical subjects

I N Marks

Publications and source records attributed to I N Marks.

At least 145 records · Page 8Linked to original sources
PubMed1981

The pharmacokinetics of ranitidine in patients with chronic duodenal ulceration.

We have studied the pharmacokinetics of ranitidine, a new H2-receptor blocker in 6 male patients suffering from chronic duodenal ulceration. In 5 patients single-dose kinetics were determined over a 24-hour period following 150 mg of ranitidine given orally and steady state kinetics were examined after treatment for 28 days with 150 mg ranitidine given twice daily. At this stage all 5 patients showed endoscopic evidence of ulcer healing. Our findings showed little inter-individual variation in elimination half-life, peak level, trough level and area under the curve (AUC). Significant differences were found between single dose and steady state situations with respect to the elimination half-life (p less than 0.01), peak levels (p less than 0.01) and area under the curve (p less than 0.05), and no differences in trough levels. The higher peak levels and larger AUC indicate increased bioavailability in steady state. The elimination half-life was shorter in steady state. The steady state kinetics of the sixth patient, a male aged 54 years, with a history of alcohol abuse and chronic duodenal ulceration who had failed to respond symptomatically to treatment with 150 mg ranitidine given twice daily for 8 weeks showed a reduction of peak level and AUC, both of which were corrected over 2 weeks by doubling the daily dose of ranitidine. The initial failure of response of this patient was likely to have been due to pharmacokinetic factors.

Administration, Oral↗
PubMed1981

Ulcer healing and relapse rates after initial treatment with cimetidine or sucralfate.

Ulcer healing and relapse rates after treatment with cimetidine and sucralfate in 112 subjects with endoscopically proven gastric and duodenal ulcers were compared in a randomized trial. Four grams of sucralfate were administered in four divided doses each day; 200 mg cimetidine was administered three times during the day with the fourth dose of 400 mg given at night. The subjects were divided into four treatment groups: (1) subjects with duodenal ulcers treated with sucralfate; (2) subjects with duodenal ulcers treated with cimetidine; (3) subjects with gastric ulcers treated with sucralfate; and (4) subjects with gastric ulcers treated with cimetidine. Endoscopy was repeated at 6 weeks after treatment was initiated; subjects with unhealed ulcers at 6 weeks were reendoscoped at 12 weeks. Eighty-three percent of duodenal ulcers in subjects treated with sucralfate healed at 6 weeks, the rest by week 12. Cimetidine-treated subjects with duodenal ulcer had healing rates of 71 and 86% at 6 and 12 weeks. Cimetidine-treated subjects with gastric ulcers showed healing rates of 75 and 89% at 6 and 12 weeks, respectively. In the gastric ulcer group, 63% of sucralfate-treated subjects were healed at 6 weeks, and 78% were healed by 12 weeks, respectively. Eighty-six of the subjects were followed for 1 year or until endoscopy showed relapse. Subjects treated with cimetidine on a short-term basis relapsed earlier than those were treated with sucralfate at 12 weeks, but at 1 year, the relapse rates were about 70% for both groups.

Aluminum↗
PubMed1980

The long-term effects of vagotomy and drainage, parietal cell vagotomy and H2 receptor antagonists on duodenal ulcers and gastric function and structure.

This paper presents a comparative retrospective analysis of the effects of vagotomy and drainage, parietal cell vagotomy (PVC) and maintenance H2 receptor antagonist (H2RA) therapy on ulcer recurrence rates, clinical status, gastric acid secretion, serum gastrin responses and gastric structure in the elective treatment of duodenal ulcer. The results indicate that the operations offered greater protection against recurrent ulceration, and that H2RA therapy provides some protection against recurrence while the patient is on continued treatment but does not alter the natural history of the disease when treatment is stopped. The evidence to date suggests that neither PCV nor H2RA therapy has altered the conventional indications for surgical treatment in duodenal ulceration.

Drainage↗
PubMed1980

The prognosis of alcohol-induced calcific pancreatitis.

A consecutive personal series of 314 patients with alcohol-induced calcific pancreatitis were admitted to a long-term follow-up study between 1959 and 1979. The patients were subdivided into four arbitrary groups according to the date of entry into study, and the mortality rate and survivor status were determined for each of these groups. Adjusted mortality rates increased progressively with the duration of follow-up, from 11% in the 1976-1979 to 73% in the 1959-1969 group. Pancreatic insufficiency dominated in patients followed up for 10 - 20 years, and pain was more prominent in the more recent follow-up groups. The survivor status in Whites was better than in Blacks, but the mortality rates were comparable. The occurrence of pain in patients who continued to drink was significantly less in the 10 - 20 year follow-up group than in those followed up for a shorter period of time.

Adult↗
PubMed1980

Mesenteric ischaemia--a diagnostic triad?

An elderly man with ischaemic heart and peripheral vascular disease presented with a 3-month history of increasingly severe postprandial epigastric pain, nausea, vomiting, diarrhoea and weight loss, associated with gastroscopic evidence of superficial antral ulceration and discoloration. The patient died shortly after admission to hospital. Autopsy showed evidence of mesenteric vascular disease and ischaemic bowel. The literature on chronic mesenteric ischaemia is briefly reviewed, and the role of arteriography is discussed.

Aged↗
PubMed1980

Is pancreatic duct obstruction or stricture a major cause of pain in calcific pancreatitis?

Forty-seven patients with calcific pancreatitis were submitted to ERCP, 24 of whom were designated 'painless' and 23 'painful', according to whether or not pain had occurred during the previous year. The pancreatic duct was cannulated in 39 of these patients. The incidence of pancreatic duct obstruction or stricture was of the same order in the painless (13/20, 65 per cent) and painful (15/19, 79 per cent) groups. Alcohol was the aetiological factor in 46 patients. Twenty-four (52 per cent) continued to drink, and were equally divided between the painless (12) and painful (12) groups. Four out of 13 in the painless and 7 out of 14 in the painful groups, with a stricture or obstruction, continued to drink. The difference was statistically not significant. These results suggest that ERCP findings of pancreatic duct obstruction or stricture need not necessarily be pertinent to the pain in patients with chronic pancreatitis.

Alcoholism↗
PubMed1979

Healing of peptic ulcers on conventional antacid therapy with or without butriptyline.

A group of ulcer patients taking conventional doses of antacids were subjected to a double-blind randomized trial to examine the possible effect of butriptyline on ulcer healing. The study failed to show any advantage of butriptyline over placebo, but this may well have been due to the very success of antacid therapy. The healing rates of gastric and duodenal ulcers in patients on conventional antacid therapy were found to be comparable to those reported with many of the newer ulcer preparations. This study also showed that larger ulcers tend to take longer to heal than small ones.

Adult↗
PubMed1979

The pathophysiology of gastric surgery.

Gastric surgery may be followed by mechanical postoperative problems, usually due to impaired gastric emptying or the afferent loop syndrome, recurrent dyspepsia, the early or late dumping syndrome, diarrhoea, or nutritional disturbances. The pathophysiological basis of these disorders is discussed and their clinical features are briefly considered.

Acute Disease↗
PubMed1978

Sweat electrolytes in chronic pancreatitis.

Sweat electrolytes were carried out in 84 adult patients with calcific pancreatitis, 51 with noncalcific pancreatitis, and the results compared to 37 adult controls. Of the patients with calcific pancreatitis, 33.5% had sweat sodium levels greater than 90 mEq/liter and 14.4% a level greater that 120 mEq/liter. Patients with noncalcific pancreatitis also had a high incidence of elevated sweat sodium levels. Sweat potassium levels were less discriminating, and there appeared to be high sweat calcium levels in a few patients so tested. The reasons for the elevated sweat sodium levels in pancreatitis is not readily apparent, and the possible relationship to heterozygous forms of cystic fibrosis is discussed.

Adolescent↗
PubMed1977

The aetiology, diagnosis and treatment of constipation and diarrhoea in geriatric patients.

Constipation and, to a lesser extent, diarrhoea, are not uncommon in the elderly and are frequently due to nonorganic causes. Despite this, disturbances in bowel habit always warrant the consideration of possible organic causes. Carcinoma of the colon and endocrine causes are frequently overlooked and rectal examination is mandatory in all patients to exclude rectal carcinoma and faecal impaction. Rectal bleeding, of course, is as alarming a symptom in the elderly as it is in younger people.

Aged↗