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Biomedical subjects

J R Bennett

Publications and source records attributed to J R Bennett.

At least 55 records · Page 3Linked to original sources
PubMed1989

How safe and acceptable is cisapride?

Cisapride has not been found to have a significant frequency of adverse reactions, except for diarrhoea which occurs in about 4% of individuals taking the drug. Cisapride is devoid of antidopaminergic effects (i.e. no neuro-endocrine effects such as prolactin increase; no extrapyramidal reactions). Clinical laboratory data show no effect of cisapride on haematology, blood chemistry, liver and kidney function. It is concluded that cisapride has a favourable safety profile.

Adult↗
PubMed1988

Balloon or bougie for dilatation of benign oesophageal stricture? An interim report of a randomised controlled trial.

Seventy one patients with benign oesophageal strictures were randomised to receive balloon or bougie dilatation. Sixty five patients were eligible for analysis. At the end of five months the balloon group had significantly more dysphagia and the calibre of the strictures in the balloon group had narrowed by a greater degree. The methods were equally safe and acceptable to patients. While the choice of the method of dilatation depends on the individual patient's needs and operator experience, bougie dilatation is more effective in reducing dysphagia and maintaining stricture patency.

Adult↗
PubMed1988

Aetiology, pathogenesis, and clinical manifestations of gastro-oesophageal reflux disease.

The aetiologic factors in gastro-oesophageal reflux disease include the free reflux of gastric juice, the composition of refluxed juice, the defensive mechanisms of the oesophagus, which are both mechanical and mucosal, and, sometimes, gastric abnormalities. Symptoms include heartburn, odynophagia, chest pain, dysphagia, regurgitation, and, occasionally, haemorrhage. Respiratory symptoms may occur. Diagnosis is based on determining the pressure and frequency of reflux (for which pH monitoring is preferred), testing for symptoms that may be caused by reflux, and assessing the degree of oesophagitis, for which endoscopy and histology are the only known techniques.

Gastric Acid↗
PubMed1987

The urinary excretion of albumin in normal pregnancy.

The urinary excretion of albumin was measured in a group of normal pregnant women at 14, 28 and 36 weeks gestation and 6 weeks postpartum. Using 2-h urine collections, the excretion rate was not found to increase during pregnancy or to differ from that in a group of non-pregnant controls. The urinary albumin to creatinine concentration ratio was greater at all stages of pregnancy than in the non-pregnant controls and greater at 36 weeks than at 14 weeks gestation. Correcting for the observed changes in serum albumin and creatinine clearance produced evidence consistent with the hypothesis that mean glomerular permeability to albumin rises progressively during pregnancy. Reasons are given why the measurement of urinary albumin excretion may be a useful screening test in some pregnant women, and may also yield useful information on the effect of multiple pregnancies on renal function. One grand multipara was studied and found to have an increased excretion of albumin at each stage of pregnancy.

Albuminuria↗
PubMed1986

[Esophageal motility].

Despite new techniques to investigate intestinal motility disorders the underlying etiologic and pathogenetic mechanisms remain uncertain in most cases. Years ago it was thought that in gastro-esophageal reflux disease the impairment of the lower esophageal sphincter is the only pathogenetic factor. In contrast to this recent studies ruled out that gastro-esophageal reflux disease seems not to be a monofactorial problem but has different pathogenetic mechanisms. The same problem has to be stated for the primary motility disorders of the esophagus. Although more often diagnosed in the last years due to more sophisticated diagnostic tools, the underlying mechanisms of the diseases are still poorly understood. In achalasia dilatation procedures seem to be the most promising therapeutic means, whereas the role of medical treatment in this disease has to be defined more clearly. Therefore a lot of work has to be done in the future to get a better basic knowledge of the motility problems of the gastrointestinal tract.

Esophageal Achalasia↗
PubMed1985

Prospective study of the Angelchik anti-reflux prosthesis.

Fifty patients with medically refractory gastro-oesophageal reflux were treated by the insertion of an Angelchik anti-reflux prosthesis. All patients had a pre-operative upper gastrointestinal endoscopy, 32 were investigated with 15 h overnight oesophageal pH studies combined with oesophageal bile sampling and 20 underwent oesophageal manometric studies. At pre-operative endoscopy 45 patients had evidence of oesophagitis and the 5 who did not had pathological reflux demonstrated on overnight pH testing. Postoperatively the main clinical problem was dysphagia which appeared to settle with time but left one-third of patients with mild dysphagia at the end of 12 months. A further 12 per cent had residual moderate to severe dysphagia which required the removal of the prosthesis in five patients (10 per cent). In only one patient was the dysphagia due to prosthetic migration and this was the first patient in the series. Subsequently, we have had no problems with prosthetic migration, disruption, or erosion into the oesophagus. The overnight pH studies confirmed the efficacy of the prosthesis in preventing reflux which correlated with symptomatic improvement. We conclude that, while the Angelchik anti-reflux prosthesis is an effective device, it has a disturbingly high incidence of postoperative dysphagia though this appears to settle with time, leaving around 10 per cent of patients with severe dysphagia which will necessitate removal of the prosthesis and one-third with mild dysphagia which may settle with the further passage of time.

Adult↗