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Biomedical subjects

W Dekker

Publications and source records attributed to W Dekker.

At least 55 records · Page 3Linked to original sources
PubMed1988

Double-blind comparison of slow-release 5-aminosalicylate and sulfasalazine in remission maintenance in ulcerative colitis.

The results of a clinical trial comparing slow-release 5-aminosalicylic acid tablets (Pentasa) and enteric-coated sulfasalazine tablets (Salazopyrin) with regard to the efficacy of maintaining ulcerative colitis patients in remission for 12 mo and with regard to safety of treatment are reported. Seventy-five patients with ulcerative colitis in remission for between 1 mo and 5 yr were included for analysis. Forty-nine men and 26 women, aged between 18 and 79 yr, received either Pentasa t.i.d. (1500 mg) plus Salazopyrin placebo or Salazopyrin t.i.d. (3 g) plus Pentasa placebo daily. Patients were assessed clinically, endoscopically, and histologically before and 3, 6, 9, and 12 mo after the start of treatment. Life-table analysis showed ongoing remission after 6 and 12 mo for Pentasa to be 63% (26 of 41) and 54% (22 of 41) and for Salazopyrin 72% (22 of 31) and 46% (14 of 31). These differences were not statistically significant. Three patients treated with Salazopyrin were withdrawn because of severe erythrodermia, anxiety and backache, and pregnancy, respectively. One patient on Salazopyrin experienced transient rises in serum urea, creatinine, and lactic dehydrogenase and another patient in this group reported slight reversible loss of hair. In the Pentasa group no side effects were recorded. We conclude that Pentasa is a well-tolerated drug, equally effective as Salazopyrin in maintenance of remission of ulcerative colitis.

Actuarial Analysis↗
PubMed1988

Comparison of beclomethasone dipropionate and prednisolone 21-phosphate enemas in the treatment of ulcerative proctitis.

In a double-blind randomized clinical trial 18 patients with exacerbations of distal ulcerative colitis were treated for 4 weeks with enemas containing either prednisolone 21-phosphate 30 mg (PP) or beclomethasone dipropionate 1 mg (BDP) a surface-active corticosteroid. All 8 patients treated with PP showed clinical and endoscopic improvement in contrast with only 4 of 10 patients treated with BDP. Endocrinologic evaluation showed a significant decrease in morning plasma cortisol, in cortisol increase after synacthen, and in urinary free cortisol excretion after PP therapy, but no changes in these variables after BDP therapy. We conclude that PP enemas are more active in the treatment of ulcerative proctitis, but they cause a suppression of the adrenal cortex, in contrast to BDP.

Adult↗
PubMed1988

Biphasic radiologic examination and endoscopy of the upper gastrointestinal tract. A comparative study.

In this prospective, blind study we compare the diagnostic results of endoscopy with a biphasic radiologic examination with drug-induced hypotony in gastric malignancy, peptic ulcer, and reflux esophagitis. Two hundred fourteen patients underwent both examinations within a week. Both disciplines detected seven malignant tumors. Twenty-three peptic ulcers were found by both; in addition, each diagnosed another ulcer. Fourteen ulcer scars were diagnosed by both; endoscopy demonstrated 10 additional scars and radiology 1. The radiologic examination detected 7 of the 37 cases of endoscopically diagnosed cases of mild reflux esophagitis, 4 of the 7 moderate cases, and 7 of 8 severe ones. A state-of-the-art radiologic examination represents an adequate initial examination in the dyspeptic patient. If the complaints suggest reflux esophagitis, the clinician has to choose between treatment and endoscopy.

Adult↗
PubMed1987

Sucralfate versus cimetidine in reflux esophagitis. A single-blind multicenter study.

A single-blind randomized multicenter study was performed in 42 patients with endoscopically documented reflux esophagitis. Patients were randomly given 400 mg cimetidine q.i.d. or a suspension of 1 g sucralfate q.i.d. for a period of 8 weeks. Forty patients were evaluated after 8 weeks. Symptomatic improvement was good and was comparable in both groups. We saw side-effects in only three patients, two on sucralfate and one on cimetidine, and these did not necessitate withdrawal from the study. Endoscopy showed improvement of esophagitis in 53% and healing in 31% of patients after sucralfate treatment. With cimetidine, improvement was seen in 67% and healing in 14%. One patient on cimetidine developed a stricture during treatment. We conclude that treatment with sucralfate improves symptoms and lessens severity of reflux esophagitis and that the results with sucralfate appear to be comparable to those obtained with cimetidine. Sucralfate is a valid alternative to H2-receptor antagonist therapy.

Adult↗
PubMed1986

Therapeutic investigations in primary sclerosing cholangitis.

There is no consensus about the necessity and the possibility of therapy in primary sclerosing cholangitis. In some patients rapid deterioration of liver function may occur due to recurrent cholangitis and cholestasis. In one such patient, we obtained radiological evidence that the cholestasis was caused, not entirely by end-stage fibrotic scarring as interpreted upon surgical exploration, but, at least in part, by biliary stasis secondary to marked irregular narrowing of the extrahepatic bile ducts, together with precipitate formation. Moreover, the biliary ductular narrowing appeared to be partly reversible, indicating that edema and inflammation were responsible for part of the narrowing. These observations prompted us to evaluate topical lavage by nasobiliary drainage, first with saline, and then followed by corticosteroid solution in eight consecutive patients with recurrent cholangitis. Based upon clinical and biochemical evaluation, our preliminary results may be summarized as favorable. However, a large-scale multicenter controlled study will be required to prove the usefulness of this approach.

Adolescent↗
PubMed1986

An international multi-clinic study comparing the therapeutic efficacy of colloidal bismuth subcitrate coated tablets with chewing tablets in the treatment of duodenal ulceration.

The results of a randomized, single-blind, multi-clinic study comparing the therapeutic efficacy and degree of oral staining of new colloidal bismuth subcitrate (CBS) coated tablets over 4 weeks of treatment in patients suffering from duodenal ulceration are reported. The data were collected from 9 clinics in the Netherlands, Belgium, Ireland, the United Kingdom, and Italy. The results from 94 patients treated with CBS coated tablets and 95 patients treated with CBS chewing tablets were statistically evaluated. Healing rates after 4 weeks of therapy appeared to be 76% for CBS coated tablets and 72% for CBS chewing tablets, so no statistically significant difference in therapeutic efficacy was seen. A highly significant degree of discolouration of all parts of the oral cavity was observed in patients treated with CBS chewing tablets, whereas only a few patients treated with CBS coated tablets experienced a slight staining of the tongue. Blood bismuth concentrations during the study had a range of less than or equal to 3 to 33 micrograms/l. The new CBS coated tablet form has an excellent patient compliance as compared to the chewing tablets.

Adolescent↗
PubMed1983

Treatment of reflux oesophagitis with ranitidine.

The efficacy of ranitidine was evaluated using a two-staged trial in patients with endoscopically moderate or severe reflux oesophagitis. The results of a six week double blind placebo controlled trial (stage I) in 36 patients shows that ranitidine (150 mg bd) is superior to placebo in the acute treatment with significant symptomatic improvement concerning heartburn and regurgitation, and in healing or improvement of endoscopic lesions. Prolonged treatment with ranitidine for another six weeks (stage II) proved to be effective in more resistant cases. No clinical side effects or significant biochemical changes were noted during this trial.

Adult↗
PubMed1981

Gastric adenomas.

Thirteen gastric adenomas were found in 11 patients in a series of approximately 11,000 standard biphasic-contrast examinations of the upper gastrointestinal tract (incidence 0.1%). In addition, endoscopy revealed 2 (4-mm) adenomas in one patient who had a negative radiographic examination. Eleven of the 15 adenomas had a maximum diameter that was less than or equal to 20 mm, and 7 lesions had smooth surfaces. These findings are different from those reported in previous North American and European radiological literature. Adenomas have a potential for malignant change, which was found in 4 (greater than or equal to 20 mm) irregularly surfaced lesions in 3 patients (early gastric carcinoma, type I and IIa).

Aged↗