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Biomedical subjects

J O Hunter

Publications and source records attributed to J O Hunter.

At least 73 records · Page 4Linked to original sources
PubMed1987

Idiopathic slow-transit constipation: whole gut transit times, measured by a new simplified method, are not shortened by opioid antagonists.

A simplified method for measuring mean whole gut transit time has been validated which avoids stool collection and is suitable for out-patients. Radio-opaque markers are swallowed daily for 14 days and the mean whole gut transit time is derived directly from an abdominal X-ray. Using this new technique, neither nalmefene (in a double-blind study of six patients) nor naloxone (in an open study of four patients) shortened mean whole gut transit time in idiopathic slow-transit constipation.

Adult↗
PubMed1986

Indium-111 leucocyte scintigraphy in the investigation and management of inflammatory bowel disease.

The results of indium-111 tropolonate leucocyte scintigraphy in 105 patients with known inflammatory bowel disease are reviewed. Scintigraphy is as sensitive as radiology in detecting and assessing the extent of active colonic disease, and probably more sensitive in assessing small bowel disease. In a further 40 patients scintigraphy was successfully used as a screening test to identify, or exclude, bowel inflammation in patients with gastrointestinal symptoms. Scintigraphy has advantages over barium studies, being safe, non-invasive, more sensitive than small bowel radiology and giving additional information such as the bowel identification of intra-abdominal abscesses. The time required to label the leucocytes (about 2 hours) and the higher unit cost, unless many scintigrams are performed, are disadvantages.

Adult↗
PubMed1985

Crohn's disease: maintenance of remission by diet.

20 patients with Crohn's disease took part in a controlled trial in which remission was maintained by either an unrefined carbohydrate fibre rich diet or a diet which excluded specific foods to which a patient was intolerant. 7 out of the 10 patients on the exclusion diet remained in remission for 6 months compared with none out of the 10 on an unrefined carbohydrate fibre rich diet (p less than 0.05, Fisher's exact test). In an uncontrolled study an exclusion diet allowed 51 out of 77 patients to remain well on the diet alone for periods of up to 51 months, and with an average annual relapse rate of less than 10%.

Adolescent↗
PubMed1985

Is continuous sulfasalazine necessary in the management of patients with ulcerative colitis? Results of a preliminary study.

The efficacy of continuous and "on-demand" sulfasalazine in the maintenance of remission of ulcerative colitis was tested in a randomized trial. Patients were reviewed at four monthly intervals for one year. Twenty-eight patients completed the trial. Ten took continuous sulfasalazine and three relapsed, while 18 took "on-demand" sulfasalazine and seven relapsed (N.S.). Rectal biopsies from each patient group were compared at each attendance, and no significant difference in histologic score was found. It is concluded that "on-demand" sulfasalazine may be as effective as continuous sulfasalazine in the maintenance of remission of ulcerative colitis.

Adult↗
PubMed1985

Symptoms of food allergy.

Adverse reactions to foods can be due to many causes, but only those involving an immunological mechanism can be defined as food allergic disease. An increasing number of gastrointestinal and other diseases are being shown to involve food intolerances. Immediate reactions with symptoms within hours of eating a particular food are most readily shown to be due to food allergy and are often associated with the presence of food-specific IgE as shown by skin prick tests and RASTs. When reactions are delayed for 24 to 48 hours or more, underlying food intolerance is harder to recognize and much less often shown to be due to allergy. At present, diagnosis and management depends on dietary manipulation, showing that symptoms improve on food avoidance and are reproduced by food challenge (preferably double-blind). Further understanding of the mechanisms involved in food allergy, in Crohn's disease and irritable bowel syndrome may allow the development of simple tests to identify the foods concerned and perhaps, in the case of allergic disease, cure by the induction of tolerance.

Colitis, Ulcerative↗
PubMed1984

Evaluation of indium scintigraphy in patients with active inflammatory bowel disease.

Recent reports have indicated a possible role for 111Indium leucocyte scintigraphy in the management of patients with acute inflammatory bowel disease. Our experience with this technique in 15 patients (nine with ulcerative colitis, six with Crohn's disease) is described. Perfect agreement was not obtained between scintigraphic appearances and other conventional means in the assessment of extent of disease. Good correlation, however, was found between disease activity and recovery of labelled leucocytes in the faeces. While this latter finding could be used as an objective means of assessing response to therapy, it is concluded that conventional indium scintigraphy, using indium oxine-labelling of mixed leucocytes, is insufficiently reliable to replace usual methods for determining extent of disease in patients with inflammatory bowel disease.

Colitis, Ulcerative↗
PubMed1984

The influence of food and repeated dosing on the bioavailability of indomethacin from a multiple-units controlled-release formulation.

A concomitant meal did not affect the extent of bioavailability of indomethacin from a multiple-units controlled-release capsule formulation containing enteric-coated pellets, but the presence of food delayed absorption. When a capsule containing 75 mg indomethacin was administered after a 12 h fast, the mean peak drug concentrations in plasma of 2.7 micrograms/ml +/- 0.8 SD occurred at a mean time of 4.2 h (range 2-6 h). When this dose was administered with a substantial breakfast, the mean of the peak plasma concentration of 2.2 micrograms/ml +/- 1.0 SD occurred at 6.4 h (range 5-12 h). Secondary peak plasma drug concentrations, occurring at approximately 14 h after dosing, were more prominent and the times to reach the second peak more variable when the capsules were administered with food. Drug bioavailability after co-administration with food was 91% of that following administration after fasting. When the controlled-release capsule was administered during 3 days in a b.i.d. dosage regimen, drug bioavailability was 103% of that from a standard capsule administered q.i.d. The mean peak level after administration of the last dose of 50 mg as controlled-release capsules was 2.5 micrograms/ml +/- 1.1 SD and the means of peak levels after the penultimate and last doses of 25 mg as standard capsules were 2.0 micrograms/ml +/- 0.3 SD and 2.1 micrograms/ml +/- 0.7 SD, respectively. The controlled-release capsule formulation was a reliable and reproducible source of indomethacin when administered as repeated doses or with food.

Adult↗
PubMed1984

Diet in the management of Crohn's disease.

Thirty-three patients with Crohn's Disease were studied to see if their symptoms were related to food intolerances. Initial treatment to produce remission of symptoms was total parenteral nutrition (20), elemental diet (2) or elimination diet (11). Twenty-nine patients reported specific food intolerances, and 21 of these remained in remission on diet alone, the mean length of remission being 15.2 months. The most important foods provoking symptoms were wheat and dairy products.

Adolescent↗
PubMed1982

Food intolerance: a major factor in the pathogenesis of irritable bowel syndrome.

Specific foods were found to provoke symptoms of irritable bowel syndrome (IBS) in 14 of 21 patients. In 6 patients who were challenged double blind the food intolerance was confirmed. No difference was detected in changes in plasma glucose, histamine, immune complexes, haematocrit, eosinophil count, or breath hydrogen excretion produced after challenge or control foods. Rectal prostaglandin E2 (PGE2), however, increased significantly, and in a further 5 patients rectal PGE2 correlated with wet faecal weight. Food intolerance associated with prostaglandin production is an important factor in the pathogenesis of IBS.

Citrus↗
PubMed1982

Bioavailability of indomethacin from two multiple-units controlled-release formulations.

Two multiple-units controlled-release indomethacin capsule formulations containing enteric-coated pellets were bioequivalent to a standard capsule formulation (taken as the reference) in respect of extent of bioavailability in a crossover study with normal human subjects. However, drug absorption from the enteric-coated pellet formulations was slower, when compared to that from the standard reference capsule. The standard reference capsule released 85% of its drug content in vitro during 10 min at pH 6.5 and 98% during 1 h at pH 7.5. On enteric-coated pellet capsule formulation (I) released 77% during 1 h at pH 6.5 and the other (II) released 10% during 1 h at pH 6.5. Release of drug from each capsule of enteric-coated pellets was complete during 1 h at pH 7.5. Although differences in areas under the plasma indomethacin concentration-time curves were not significantly different, the peak plasma levels and the times of their occurrence indicated that the absorption rates of indomethacin decreased in the order, reference formulation greater than pellet formulation I greater than pellet formulation II, which was the same rank order as that of their dissolution rates in vitro. The data indicated that multiple units controlled-release formulations represent a reliable and reproducible source of indomethacin, which by avoiding extremes of local or systemic drug concentrations also should be better tolerated by individuals susceptible to unwanted gastrointestinal and centrally-mediate side-effects.

Adult↗
PubMed1981

Highly selective vagotomy and pyloric dilatation for duodenal ulcer with stenosis.

This paper presents the results obtained in 15 patients with duodenal ulcer and stenosis who were treated more than 3 years ago by highly selective vagotomy (HSV) and dilatation of the stenosis without a gastric drainage procedure. Patients were taking solid food 3--6 days postoperatively and were discharged after 7--14 days. There have been no recurrent stenoses. Fourteen of the 15 patients were Visick grade 1 or 2 at their last visit. One patient has a recurrent ulcer, but no restenosis. Barium meals performed on 6 patients with severe stenosis preoperatively showed satisfactory gastric emptying 1--3 years postoperatively. HSV and pyloric dilatation seems to be a safe and effective procedure for the treatment of pyloric stenosis due to chronic duodenal ulceration.

Dilatation↗